• Pierluigi Benedetti Panici, Maurizio Anceschi, Maria Luisa Borgia, Luciano Bresadola, Gabriele Masselli, Tiziana Parasassi, Giuseppina Perrone, Fetal Maternal Risk Group, and Roberto Brunelli.
• Department of Gynecology, Obstetrics and Urology, Universita Sapienza, Roma, Italy.
• J. Matern. Fetal. Neonatal. Med. 2012 Dec 1;25(12):2512-6.

ObjectiveTo evaluate whether aorta balloon occlusion decreases the rate of hysterectomies and maternal morbidity during extirpative surgery of placenta previa accreta or increta.MethodsWe prospectively assessed 33 consecutive patients with placenta praevia and MRI diagnosis of multifocal accreta or increta. Manual removal of the placenta was performed during a scheduled caesarean delivery. In 15 patients, surgery was preceded by balloon catheterization of the abdominal aorta (Intra Abdominal Balloon Occlusion: IABO); 18 patients refusing IABO were considered as controls. We used Fisher's exact test for categorical variables and Mann-Whitney test for continuous variables.ResultsIn the IABO group we observed significant decreases in incidence of hysterectomy, estimated blood loss, number of transfused units of red blood cells, postoperative stay and admission to Intensive Care Unit. No IABO-related complications were reported.ConclusionsDuring scheduled caesarean section for placenta previa multifocally accreta or increta, IABO can prevent hysterectomy in many cases and improves perioperative outcome as it gives the operator time to achieve the haemostasis via curettage and oversewing of the implantation site with acceptable blood loss.

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