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World J Emerg Surg. 2018 Sep 24;13:44. doi: 10.1186/s13017-018-0205-2. eCollection 2018.

Resuscitative endovascular balloon occlusion of the aorta deployed by acute care surgeons in patients with morbidly adherent placenta: a feasible solution for two lives in peril.

Author information

1
1Clinical Research Center, Fundacion Valle del Lili, Cali, Colombia.
2
2Center for Surgery and Public Health - Brigham and Women's Hospital, Harvard Medical School & Harvard T.H. Chan School of Public Health, Boston, MA USA.
3
6Critical Care Obstetrics, Department of Gynecology and Obstetrics, Fundacion Valle del Lili, Cali, Colombia.
4
3Trauma and Acute Care Surgery Division, Department of Surgery, Fundacion Valle del Lili, Cali, Colombia.
5
4R. Adams Cowley Shock Trauma Center, Baltimore, MD USA.
6
5Trauma Division and Trauma and Emergency Surgery Fellowship, Universidad del Valle, Cali, Colombia.
7
7School of Medicine, Universidad ICESI, Cali, Colombia.

Abstract

Morbidly adherent placenta (MAP), which includes accreta, increta, and percreta, is a condition characterized by the invasion of the uterine wall by placental tissue. The condition is associated with higher odds of massive post-partum hemorrhage. Several interventions have been developed to improve hemorrhage-related outcomes in these patients; however, there is no evidence to prefer any intervention over another. Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an endovascular intervention that may be useful and effective to reduce hemorrhage and transfusions in MAP patients. The objective of this narrative review is to summarize the evidence for REBOA in patients with MAP. We posit that acute care surgeons can perform REBOA for patients with MAP.

KEYWORDS:

Abnormal placentation; Endovascular procedures; Placenta accreta; REBOA

Conflict of interest statement

Not applicableNot applicableThe authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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