American Journal of Obstetrics & Gynecology
Volume 197, Issue 4 , Pages 402.e1-402.e5, October 2007

Case-control comparison of cesarean hysterectomy with and without prophylactic placement of intravascular balloon catheters for placenta accreta

Presented at the 27th Annual Clinical Meeting of the Society for Maternal–Fetal Medicine, San Francisco, CA, Feb. 5-10, 2007.

  • Vineet Shrivastava, MD

      Affiliations

    • Divisions of Maternal-Fetal Medicine, Departments of Obstetrics and Gynecology, Irvine Medical Center, University of California, Orange, CA
    • ,
  • Michael Nageotte, MD

      Affiliations

    • Long Beach Memorial Medical Center/Miller’s Children’s Hospital, Long Beach, CA.
    • ,
  • Carol Major, MD

      Affiliations

    • Divisions of Maternal-Fetal Medicine, Departments of Obstetrics and Gynecology, Irvine Medical Center, University of California, Orange, CA
    • ,
  • Michael Haydon, MD

      Affiliations

    • Divisions of Maternal-Fetal Medicine, Departments of Obstetrics and Gynecology, Irvine Medical Center, University of California, Orange, CA
    • ,
  • Deborah Wing, MD

      Affiliations

    • Divisions of Maternal-Fetal Medicine, Departments of Obstetrics and Gynecology, Irvine Medical Center, University of California, Orange, CA

Objective

The objective of the study was to compare outcomes of women with placenta accreta who underwent cesarean hysterectomy with and without prophylactic intravascular balloon catheters.

Study Design

Case-control study of women at risk for placenta accreta identified using hospital databases and billing records from January 1995 to January 2006. Subjects with preoperative intravascular balloon catheter (BC) placement plus hysterectomy were compared with those that had hysterectomy alone.

Results

Sixty-nine subjects had cesarean hysterectomy performed for placenta accreta; 19 subjects had balloon catheters plus hysterectomy and 50 subjects had hysterectomy alone. No significant differences were noted in estimated blood loss (P = .79), transfused blood products (P = .60), operative time (P = .85), and postoperative hospital days (P = .85). There were no significant differences in secondary outcomes between groups. Three of the 19 BC subjects (15.8%) had complications from catheter placement; 2 required stent placement and/or arterial bypass.

Conclusion

Prophylactic intravascular balloon catheters did not benefit women with placenta accreta undergoing cesarean hysterectomy.

Key words: cesarean hysterectomy, intravascular balloon catheter, placenta accreta

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 Reprints not available from the authors.

 Cite this article as: Shrivastava V, Nageotte M, Major C, et al. Case-control comparison of cesarean hysterectomy with and without prophylactic placement of intravascular balloon catheters for placenta accreta. Am J Obstet Gynecol 2007;197:402.e1-402.e5.

PII: S0002-9378(07)00941-6

doi:10.1016/j.ajog.2007.08.001

American Journal of Obstetrics & Gynecology
Volume 197, Issue 4 , Pages 402.e1-402.e5, October 2007

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