{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T07:42:57Z","timestamp":1780990977333,"version":"3.54.1"},"reference-count":43,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2019,7,7]],"date-time":"2019-07-07T00:00:00Z","timestamp":1562457600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aust NZ J Obst Gynaeco"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Morbidly adherent placenta is potentially life\u2010threatening, often requiring technically difficult surgery and large blood loss. Use of intravascular balloon occlusion with or without hysterectomy to reduce blood loss is increasing despite associated morbidity and lack of evidence of efficacy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To evaluate if prophylactic use of vascular balloon occlusion at the time of planned caesarean hysterectomy for antenatally diagnosed morbidly adherent placenta reduces blood loss and transfusion requirements, and determine rate of associated complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>A systematic review of PubMed and Medline covering January 1997 to December 2018 was conducted. Key words included placenta accreta, increta, percreta, and morbidly adherent placenta, balloon, interventional radiology, embolization, and caesarean hysterectomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Nineteen studies were included. Only three studies had appropriate controls: two with balloon placement in the internal iliac arteries and one in the common iliac arteries. One showed no difference in blood loss or transfusion requirements, the second showed a reduction in cases of percreta only and the third reported reduction in blood loss. Only few studies reported objective measures of blood loss. Blood loss and transfusion were still high (2.26\u00a0L and 3.79\u00a0units, respectively) despite use of vascular balloons. Balloon catheter use was associated with a 7.5% rate of complications; 4.5% were minor and 3.0% major.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>There is a large body of poor data evaluating efficacy of prophylactic vascular balloon occlusion in cases of planned caesarean hysterectomy for known morbidly adherent placenta. Limited relevant data provide only scant evidence that these techniques are beneficial in reducing blood loss, despite associated significant complications.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajo.13027","type":"journal-article","created":{"date-parts":[[2019,7,8]],"date-time":"2019-07-08T04:08:14Z","timestamp":1562558894000},"page":"608-615","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Vascular balloon occlusion and planned caesarean hysterectomy for morbidly adherent placenta: A systematic review"],"prefix":"10.1111","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4602-4329","authenticated-orcid":false,"given":"Michael","family":"Makary","sequence":"first","affiliation":[{"name":"Southland Hospital SDHB Invercargill New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5750-5726","authenticated-orcid":false,"given":"Prathima","family":"Chowdary","sequence":"additional","affiliation":[{"name":"North Shore Hospital WDHB Auckland New Zealand"},{"name":"University of Auckland Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenny Ann","family":"Westgate","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology University of Auckland Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,7,7]]},"reference":[{"key":"e_1_2_5_2_1","first-page":"31","article-title":"Placenta accreta: changing clinical aspects and outcome","volume":"56","author":"Read JA","year":"1980","journal-title":"Obstet Gynecol"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2004.12.074"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-017713"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.7863\/jum.2008.27.9.1275"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.1926"},{"key":"e_1_2_5_7_1","unstructured":"RANZCOG.Placenta Accreta. 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