Iliac artery rupture related to balloon insertion for placenta accreta causing maternal hemorrhage and neonatal compromise
Open accessAbstract
Purpose The use of internal iliac artery balloons for prevention of hemorrhage in cases of placenta accreta is increasing. Most described complications of this technique are maternal and thromboembolic in nature. Complications related to vascular rupture are rare, their presentation is not well described, and the resultant neonatal consequences are infrequently reported.Clinical features A 35-yr-old term parturient with suspected placenta accreta underwent prophylactic endovascular placement of iliac balloons prior to Cesarean delivery. The patient complained of contraction-like pain during balloon placement, and an arterial wall tear was discovered after abdominal incision. This produced significant maternal bleeding and the birth of a neonate with an umbilical venous pH of 6.95 and Apgar scores of 3 and 7.Conclusion In addition to the known maternal risks, fetal risks must be considered when planning the placement of endovascular iliac balloons during pregnancy. We recommend continuous monitoring of maternal and fetal status when performing the procedure. Contraction-like pain during placement should raise the suspicion of arterial disruption.
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The value of prophylactic placement of balloon catheters in the iliac arteries in cases of placenta accreta has been more controversial, mainly because of the higher risks of complications than embolisation, including iliac artery thrombus or rupture, and ischaemic nerve injury.
“The value of prophylactic placement of balloon catheters in the iliac arteries in cases of placenta accreta has been more controversial.This is mainly because of the higher risks of complications than embolisation, including iliac artery thrombus or rupture, and ischaemic nerve injury.[216][217][218][219]”
From Placenta Praevia and Placenta Accreta: Diagnosis and Management: Green‐top Guideline No. 27a (2019) · cites this paper as [217]
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- Authors
- Gagnon, J., Boucher, L., Kaufman, I., Brown, R., & Moore, A.
- Affiliations
- McGill University Health Centre (CA)
- Corresponding author
- Moore, Albert
- Venue
- Canadian Journal of Anesthesia/Journal canadien d'anesthésie
- Published
- 2013-10-03
- Volume
- 60
- Issue
- 12
- Pages
- 1212-1217
- ISSN
- 0832-610X (ISSN-L)
- 1496-8975
- OpenAlex
- W83249090
- Cited by
- 33
- References
- 17
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 2 · 2023: 4 · 2022: 6 · 2021: 5 · 2020: 1 · 2019: 1 · 2018: 5 · 2017: 3 · 2016: 1 · 2015: 2
- FWCI
- 0.93
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Canadian Journal of Anesthesia/Journal canadien d anesthésie (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and fetal healthcare
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Health Sciences › Medicine › Biochemistry › Blood transfusion and management
- Keywords
- placenta accreta, iliac artery rupture, maternal hemorrhage, neonatal acidosis, cesarean section, vascular complications, fetal compromise
- MeSH terms
- Adult, Female, Postpartum Hemorrhage, Humans, Iliac Artery, Infant, Newborn, Placenta Accreta, Pregnancy, Rupture, Balloon Occlusion
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