• Julie R Whittington, Megan E Pagan, Bryan D Nevil, Kyle J Kalkwarf, SharawiNadir ElNEDepartment of Anesthesia, Division of Obstetric Anesthesia, University of Arkansas for Medical Sciences, Little Rock, AR, USA., Dawn S Hughes, and Adam T Sandlin.
• Department of Obstetrics & Gynecology, Division of Maternal Fetal Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
• J. Matern. Fetal. Neonatal. Med. 2020 Aug 11: 1-4.

ObjectiveTo compare prophylactic and emergent resuscitative endovascular balloon occlusion of the aorta (REBOA) catheter placement in the management of placenta accreta spectrum (PAS).Study DesignRetrospective chart review of all patients with PAS (January 2018 to January 2020) at a single tertiary center who underwent prophylactic or emergent REBOA for cesarean hysterectomy for PAS.ResultsA total of 16 pregnant patients with PAS underwent percutaneous REBOA placement by acute care surgeons in collaboration with a multi-disciplinary PAS team. The REBOA catheter was placed prophylactically in 11 cases and emergently in 5 cases. No complications occurred in the prophylactic placement group. In the emergent placement group, 3 of 4 surviving patients had vascular access site complications requiring intervention.ConclusionA multidisciplinary approach for the management of PAS utilizing REBOA is feasible in the setting of both planned and emergent cesarean hysterectomy and can aid in the control of acute hemorrhage. The risk for vascular access site complications related to REBOA catheter placement is higher in the emergent setting compared to prophylactic placement.

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