Two approaches for placenta accreta spectrum: B-lynch suture versus pelvic artery endovascular balloon

Maya Frank Wolf, Shlomit Maymon, Oleg Shnaider, Jonathan Singer-Jordan, Ron Maymon, Jacob Bornstein, Joseph Tovbin

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Purpose: Management of patients with placenta accreta spectrum (PAS) varies widely, and scarce data exist concerning its management. The current study compared two different surgical approaches in the management of PAS: the B-lynch approach (Group A) compared to the endovascular balloon catheters (Group B) Methods: A retrospective cohort study in two tertiary university-affiliated hospitals between the years 2004 and 2015. Elective cesarean section was planned at 35–37 weeks of gestation. One center utilized the B-lynch approach and the second utilized the endovascular balloon catheter approach. Results: The cesarean hysterectomy rate was significantly higher in the Group A approach compared to Group B (36.1 versus 29.2%, p =.00). The number of packed cells units administered during and postoperatively were higher in the Group A compared with Group B (p =.006 and.043, respectively). Overall, surgery length and hospitalization duration were shorter in patients who underwent cesarean hysterectomy compared with those who underwent uterine preservation (B-lynch or endovascular balloon catheters) (p =.000 and p =.004, respectively). Conclusions: The endovascular balloon technique seems to be a better option for uterine preservation due to less blood loss and higher postoperative hemoglobin level. Nevertheless, for those women who have completed their family planning, cesarean hysterectomy with the placenta left in situ is the safer and more suitable option.

Original languageEnglish
Pages (from-to)2711-2717
Number of pages7
JournalJournal of Maternal-Fetal and Neonatal Medicine
Issue number16
StatePublished - 17 Aug 2020

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© 2019, © 2019 Informa UK Limited, trading as Taylor & Francis Group.


  • Cesarean hysterectomy
  • endovascular balloon technique
  • placenta accreta management
  • postoperative hemoglobin level
  • uterine preservation


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