{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T23:26:51Z","timestamp":1783466811716,"version":"3.55.0"},"reference-count":27,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2020,7,23]],"date-time":"2020-07-23T00:00:00Z","timestamp":1595462400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Dongkook Lifescience Co.","award":["DK-IIT-2019-02"],"award-info":[{"award-number":["DK-IIT-2019-02"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Preoperative prophylactic balloon-assisted occlusion (PBAO) of the internal iliac arteries minimizes blood loss and facilitates surgery performance, through reductions in the rate of uterine perfusion, which allow for better control in hysterectomy performance, with decreased rates of bleeding and surgical complications. We aimed to investigate the maternal and fetal outcomes associated with PBAO use in women with placenta increta or percreta. Material and Methods: The records of 42 consecutive patients with a diagnosis of placenta increta or percreta were retrospectively reviewed. Of 42 patients, 17 patients (40.5%) with placenta increta or percreta underwent cesarean delivery after prophylactic balloon catheter placement in the bilateral internal iliac artery (balloon group). The blood loss volume, transfusion volume, postoperative hemoglobin changes, rates of hysterectomy and hospitalization, and infant Apgar score in this group were compared to those of 25 similar women who underwent cesarean delivery without balloon placement (surgical group). Results: The mean intraoperative blood loss volume in the balloon group (2319 \u00b1 1191 mL, range 1000\u20134500 mL) was significantly lower than that in the surgical group (4435 \u00b1 1376 mL, range 1500\u201310,500 mL) (p = 0.037). The mean blood unit volume transfused in the balloon group (2060 \u00b1 1154 mL, range 1200\u20138000 mL) was significantly lower than that in the surgical group (3840 \u00b1 1464 mL, range 1800\u201315,200 mL) (p = 0.043). There was no significant difference in the postoperative hemoglobin change, hysterectomy rates, length of hospitalization, or infant Apgar score between the groups. Conclusion: PBAO of the internal iliac artery prior to cesarean delivery in patients with placenta increta or percreta is a safe and minimally invasive technique that reduces the rate of intraoperative blood loss and transfusion requirements.<\/jats:p>","DOI":"10.3390\/medicina56080368","type":"journal-article","created":{"date-parts":[[2020,7,23]],"date-time":"2020-07-23T10:14:06Z","timestamp":1595499246000},"page":"368","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Preoperative Prophylactic Balloon-Assisted Occlusion of the Internal Iliac Arteries in the Management of Placenta Increta\/Percreta"],"prefix":"10.3390","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5762-7064","authenticated-orcid":false,"given":"Soo Buem","family":"Cho","sequence":"first","affiliation":[{"name":"Department of Radiology, Ewha Womans University, College of Medicine, Seoul 07804, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seok Jin","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Radiology, Gyeongsang National University Hospital, Jinju 52727, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sangmin","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Radiology, Gyeongsang National University Hospital, Jinju 52727, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jung Ho","family":"Won","sequence":"additional","affiliation":[{"name":"Department of Radiology, Gyeongsang National University Hospital, Jinju 52727, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ho Cheol","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Radiology, Gyeongsang National University Hospital, Jinju 52727, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji Young","family":"Ha","sequence":"additional","affiliation":[{"name":"Department of Radiology, Gyeongsang National University Changwon Hospital, Changwon 51472, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin Il","family":"Moon","sequence":"additional","affiliation":[{"name":"Department of Radiology, Gyeongsang National University Changwon Hospital, Changwon 51472, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji Kwon","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Gyeongsang National University Changwon Hospital, Changwon 51472, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji Eun","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Gyeongsang National University Changwon Hospital, Changwon 51472, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2832-8900","authenticated-orcid":false,"given":"Sung Eun","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Radiology, Gyeongsang National University Changwon Hospital, Changwon 51472, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,7,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1158","DOI":"10.2214\/AJR.07.2417","article-title":"Perioperative endovascular internal iliac artery occlusion balloon placement in management of placenta accreta","volume":"189","author":"Tan","year":"2007","journal-title":"Am. J. Roentgenol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2512","DOI":"10.3109\/14767058.2012.712566","article-title":"Intraoperative aorta balloon occlusion: Fertility preservation in patients with placenta previa accreta\/increta","volume":"25","author":"Panici","year":"2012","journal-title":"J. Matern.-Fetal Neonatal Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2622","DOI":"10.1080\/14767058.2018.1442429","article-title":"Maternal and neonatal outcomes of placenta increta and percreta from a multicenter study in China","volume":"32","author":"Zhang","year":"2019","journal-title":"J. Matern.-Fetal Neonatal Med."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Committee on Obstetric Practice (2012). Committee opinion no. 529: Placenta accreta. Obstet. Gynecol., 120, 207\u2013211.","DOI":"10.1097\/AOG.0b013e318262e340"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1097\/00006254-199808000-00024","article-title":"Diagnosis and management of placenta percreta: A review","volume":"53","author":"Hudon","year":"1998","journal-title":"Obstet. Gynecol. Surv."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1488","DOI":"10.1007\/s00270-018-1983-3","article-title":"Prophylactic Placement of Internal Iliac Balloons in Patients with Abnormal Placental Implantation: Maternal and Foetal Outcomes","volume":"41","author":"Nicholson","year":"2018","journal-title":"Cardiovasc. Interv. Radiol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"402.e1","DOI":"10.1016\/j.ajog.2007.08.001","article-title":"Case-control comparison of cesarean hysterectomy with and without prophylactic placement of intravascular balloon catheters for placenta accreta","volume":"197","author":"Shrivastava","year":"2007","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/j.ijoa.2010.09.012","article-title":"Multiple complications following the use of prophylactic internal iliac artery balloon catheterisation in a patient with placenta percreta","volume":"20","author":"Bishop","year":"2011","journal-title":"Int. J. Obstet. Anesth."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"758","DOI":"10.1007\/s00270-011-0166-2","article-title":"Perioperative temporary occlusion of the internal iliac arteries as prophylaxis in cesarean section at risk of hemorrhage in placenta accreta","volume":"34","author":"Carnevale","year":"2011","journal-title":"Cardiovasc. Intervent. Radiol."},{"key":"ref_10","first-page":"15","article-title":"Cesarean Hysterectomy for Abnormal Placentation Using Balloon Occlusion of the Common Iliac Artery: Case Series","volume":"3","author":"Koshiyama","year":"2017","journal-title":"Women Health"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1515\/jpm-2011-0156","article-title":"Individual decisions in placenta increta and percreta: A case series","volume":"40","author":"Chantraine","year":"2012","journal-title":"J. Perinat. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"723","DOI":"10.1016\/S0002-9378(97)70582-9","article-title":"Placenta percreta: Balloon occlusion and embolization of the internal iliac arteries to reduce intraoperative blood losses","volume":"176","author":"Dubois","year":"1997","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"651","DOI":"10.3346\/jkms.2010.25.4.651","article-title":"Prophylactic hypogastric artery ballooning in a patient with complete placenta previa and increta","volume":"25","author":"Yi","year":"2010","journal-title":"J. Korean Med. Sci."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1521","DOI":"10.2214\/ajr.176.6.1761521","article-title":"Prophylactic perioperative hypogastric artery balloon occlusion in abnormal placentation","volume":"176","author":"Kidney","year":"2001","journal-title":"Am. J. Roentgenol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1195","DOI":"10.1097\/01.RVI.0000086532.86489.97","article-title":"Internal Iliac Artery Embolization before Hysterectomy for Placenta Accreta","volume":"14","author":"Chou","year":"2003","journal-title":"J. Vasc. Interv. Radiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1756","DOI":"10.1016\/j.ajog.2005.08.033","article-title":"Temporary balloon occlusion of the common iliac artery: New approach to bleeding control during cesarean hysterectomy for placenta percreta","volume":"193","author":"Shih","year":"2005","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1007\/s00270-005-0023-2","article-title":"Balloon-assisted occlusion of the internal iliac arteries in patients with placenta accreta\/percreta","volume":"29","author":"Bodner","year":"2006","journal-title":"Cardiovasc. Interv. Radiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1487","DOI":"10.1007\/s00270-015-1102-7","article-title":"Foetal Radiation Dose during Prophylactic Occlusion Balloon Placement for Morbidly Adherent Placenta","volume":"38","author":"Semeraro","year":"2015","journal-title":"Cardiovasc. Interv. Radiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"938","DOI":"10.1016\/S0002-9378(97)70624-0","article-title":"Uterine artery embolization: An underused method of controlling pelvic hemorrhage","volume":"176","author":"Vedantham","year":"1997","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_20","first-page":"31","article-title":"Placenta accreta: Changing clinical aspects and outcome","volume":"56","author":"Read","year":"1980","journal-title":"Obstet. Gynecol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"3386","DOI":"10.1080\/14767058.2018.1463986","article-title":"The role of prophylactic internal iliac artery ligation in abnormally invasive placenta undergoing caesarean hysterectomy: A randomized control trial","volume":"32","author":"Hussein","year":"2019","journal-title":"J. Matern.-Fetal Neonatal Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"526","DOI":"10.1097\/AOG.0b013e3181d066d4","article-title":"Maternal outcome after conservative treatment of placenta accreta","volume":"115","author":"Sentilhes","year":"2010","journal-title":"Obstet. Gynecol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"447","DOI":"10.3109\/01443615.2012.669429","article-title":"Planned conservative management of placenta percreta","volume":"32","author":"Wong","year":"2012","journal-title":"J. Obstet. Gynaecol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1016\/S1028-4559(09)60310-7","article-title":"Failure of conservative treatment for placenta increta","volume":"48","author":"Liao","year":"2009","journal-title":"Taiwan J. Obstet. Gynecol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1111\/j.1600-0412.2012.01451.x","article-title":"Balloon occlusion of the internal iliac arteries in the multidisciplinary management of placenta percreta","volume":"92","author":"Clausen","year":"2013","journal-title":"Acta Obstet. Gynecol. Scand."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"798","DOI":"10.1007\/s11547-017-0777-z","article-title":"Prophylactic occlusion balloon placement in internal iliac arteries for the prevention of postpartum haemorrhage due to morbidly adherent placenta: Short term outcomes","volume":"122","author":"Angileri","year":"2017","journal-title":"Radiol. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1002\/(SICI)1520-6661(199907\/08)8:4<173::AID-MFM7>3.0.CO;2-V","article-title":"Placenta accreta: Comparison of cases managed with and without pelvic artery balloon catheters","volume":"8","author":"Levine","year":"1999","journal-title":"J. Matern.-Fetal Med."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/56\/8\/368\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T09:51:07Z","timestamp":1760176267000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/56\/8\/368"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,23]]},"references-count":27,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2020,8]]}},"alternative-id":["medicina56080368"],"URL":"https:\/\/doi.org\/10.3390\/medicina56080368","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7,23]]}}}