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Arterial embolus during common iliac balloon catheterization at cesarean hysterectomy
Mark F Sewell1, David Rosenblum, Hugh Ehrenberg
1Department of Maternal-Fetal Medicine, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH 44109-1989, USA. msewell@metrohealth.org
Background:
Placenta accreta is associated with significant maternal morbidity. Prophylactic iliac artery balloon placement has been described as a treatment adjunct to minimize maternal risk of excessive blood loss at hysterectomy.
Case:
A 37-year-old multigravida presented at 37 weeks of gestation with a known placenta previa and suspected placenta accreta. Iliac artery balloon catheters were placed immediately before cesarean delivery. The balloons were inflated after the infant was delivered, and placental-site hemorrhage required a cesarean hysterectomy with a 1,500-mL blood loss. A left popliteal arterial thrombus diagnosed postoperatively required thromboembolectomy. The patient was discharged home on postoperative day 5 with no further sequelae.
Conclusion:
Prophylactic arterial balloon occlusion may be associated with risks unique to pregnant women.
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