Perinatology.  2019 Sep;30(3):175-178. 10.14734/PN.2019.30.3.175.

Intraoperative Use of Resuscitative Endovascular Balloon Occlusion of the Aorta for Hemorrhage Control in Woman with Placenta Percreta Involving the Bladder

Affiliations
  • 1Department of Thoracic and Cardiovascular Surgery, Dankook University Hospital, Cheonan, Korea.
  • 2Department of General Surgery, Trauma Center, Dankook University Hospital, Cheonan, Korea.
  • 3Department of Obstetrics and Gynecology, Dankook University Hospital, Cheonan, Korea. soo8541@hanmail.net

Abstract

A 42-year-old woman with irregular uterine contractions and a history of two prior cesarean sections was admitted. At 35 weeks of gestation, preterm labor with vaginal bleeding led to a cesarean section. During placenta removal it was revealed to be a percreta and uncontrollable massive bleeding ensued. Intraoperative resuscitative endovascular balloon occlusion of the aorta (REBOA) was performed, which has been used as a resuscitative adjunct for trauma patients with noncompressible torso hemorrhage and a hysterectomy was successfully completed. Gauze packing for temporary abdominal closure and angio-embolization were performed to further control bleeding. The packed gauze was removed 2 days later and the patient recovered uneventfully. To the best of our knowledge, this is the first reported case in South Korean literature of the successful application of a REBOA as a salvage treatment for hemorrhage control, and REBOA could be a life-saving procedure for patients with peripartum hemorrhaging.

Keyword

Hysterectomy; Placenta; Postpartum hemorrhage; Balloon occlusion

MeSH Terms

Adult
Aorta*
Balloon Occlusion*
Cesarean Section
Female
Hemorrhage*
Humans
Hysterectomy
Obstetric Labor, Premature
Peripartum Period
Placenta Accreta*
Placenta*
Postpartum Hemorrhage
Pregnancy
Salvage Therapy
Torso
Urinary Bladder*
Uterine Contraction
Uterine Hemorrhage
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