• Michele Salvagno, Marta Grinza, Giacomo Coppalini, Alessandro de Cassai, Rossana Soloperto, Alessia Degrassi, Andrew Carlin, Filippo Annoni, Fabrizia Calabrese, and Fabio Silvio Taccone.
• Department of Intensive Care, Hôpital Universitaire de Bruxelles (HUB), Brussels, Belgium. Electronic address: michele.salvagno@ulb.be.
• Int J Obstet Anesth. 2024 Nov 1; 60: 104260104260.

AbstractPostpartum hemorrhage (PPH) remains one of the leading causes of maternal mortality worldwide, with a significant impact on global health. Optimal management of PPH involves distinct steps executed simultaneously by a multidisciplinary approach, with anesthesiologists playing a key role in hemodynamic control and patient resuscitation. In this context, an aortic blood flow interruption through an internal balloon should be considered a rescue option among the various opportunities, to treat or prevent abdominal hemorrhages. Given this perspective, there is increasing interest in the role of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA), originally used in trauma and military medicine, which has emerged as a novel strategy for managing PPH. Indeed, this technique has shown promise in managing severe cases of PPH, especially where traditional measures are insufficient. It also offers potential as a prophylactic measure in pregnancies with high risk for PPH, such as in the case of placenta accrete spectrum. This review aims to examine the efficacy, safety, and potential applications of REBOA in PPH management and prevention. At the same time, challenges such as the need for skilled operators, potential complications, costs, and the consideration of fetal safety were also discussed. REBOA presents as a promising tool against PPH, with efficacy in reducing blood loss, preserving fertility, and potentially decreasing maternal mortality and improving outcomes. However, its implementation requires careful consideration, training, and further research to establish clear guidelines for its use in obstetric care.Copyright © 2024 Elsevier Ltd. All rights reserved.

19 keywords...

hide…