The use of pre-caesarean prophylactic intra-arterial balloon catheters for suspected placenta accreta

Maya Frank Wolf, Jonathan Singer-Jordan, Oleg Shnaider, Ala Aiob, Inshirah Sgayer, Jacob Bornstein

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Introduction: The incidence of placenta accreta (PA) has markedly increased in the United States, from 1/30 000 in 1950 to 1/731 deliveries in 2011. Although placenta praevia after prior caesarean sections (CS) is the most important risk factor for PA, other risk factors make up 1–5% of PA occurrences. At our referral hospital, we use the pre-caesarean prophylactic balloon catheter with or without post-surgery embolisation in a hybrid room. Here, we evaluate the role of prior CS and placenta praevia on the outcome of this procedure. Materials and Methods: This retrospective cohort analysis included 61 women during the years 2004–2016 with sonographic suspicion of PA who underwent balloon catheterisation prior to CS. Results: Eleven women had no previous CS (18%). Mean previous CS rate was 1.85. Six women (9.8%) had previous dilatation and curettage (D&C); 36.4% of women with no previous CS had previous D&C compared with 4% of women with previous CS (P = 0.008). Placenta praevia was sonographically diagnosed in 55 women (90.2%). There was a higher rate of caesarean hysterectomy in women with previous CS than in those without (32% vs 0%, P = 0.052) but no significant difference in blood product requirements (45.5% vs 66%, P = 0.303). There was no significant difference in hysterectomy rate, blood transfusion or surgery duration between women with and without placenta praevia (P = 0.648, 0.594, 0.995, respectively). Conclusion: Previous CS rather than placenta praevia is a strong indicator of hysterectomy in cases of PA. Different risk factors for PA do not affect blood transfusion rates or surgery duration.

Original languageEnglish
Pages (from-to)528-532
Number of pages5
JournalAustralian and New Zealand Journal of Obstetrics and Gynaecology
Issue number4
StatePublished - Aug 2019

Bibliographical note

Publisher Copyright:
© 2018 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists


  • blood transfusion
  • caesarean section
  • hysterectomy
  • placenta accreta


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