4-French Aortic Balloon Occlusion in Cesarean Hysterectomy for Placenta Accreta Spectrum Disorder.

Cohort studyObstetrics and gynecology· Jun 2025

4-French Aortic Balloon Occlusion in Cesarean Hysterectomy for Placenta Accreta Spectrum Disorder.

Jessian L Munoz, J Connor Mulhall, Yamely H Mendez … Amir A Shamshirsaz

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Transfusion MedicineCohort studyTreatmentQ1IF 3.4

Aortic balloon inflation linked to lower blood loss in placenta accreta spectrum hysterectomy

4-French Aortic Balloon Occlusion in Cesarean Hysterectomy for Placenta Accreta Spectrum Disorder.

Jessian L Munoz … Amir A Shamshirsaz

Obstetrics and gynecology · Jun 2025

Purpose

To evaluate whether using a 4-French balloon aortic occlusion device was associated with lower blood loss and subsequent blood transfusions in placenta accreta spectrum (placenta accreta spectrum) cesarean hysterectomy.

Methods

We compared patients who had a 4-French aortic balloon inflated with those who had a sheath placed without balloon inflation and those who had no sheath placement for planned cesarean hysterectomy.

n = 81 patients

Results

1,526±635 mL vs 2,686±1,420 mL

balloon inflation cut blood loss by over 1,100 mL versus no sheath

n = 81 patients

More results

Twenty-seven patients (27/81, 33.3%) did not have the 4-French sheath placement at time of surgery.

A 4-French balloon sheath was placed in 54 patients; among these, 25 had sheath-only placement with no balloon inflation, and 29 had aortic balloon inflation during cesarean hysterectomy.

More results

Operative time was longer in surgeries with balloon inflation compared with those with no sheath placement (319±93 minutes vs 244±64 minutes, P <.01).

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Conclusion · 1 of 2

In our cohort, inflation of a 4-French aortic occlusion balloon for placenta accreta spectrum surgeries was associated with lower blood loss and less blood transfusions but longer operative times compared with no sheath placement.

Conclusion · 2 of 2

Larger studies are needed to assess for rare outcomes and complications.