Case-control comparison of cesarean hysterectomy with and without prophylactic placement of intravascular balloon catheters for placenta accreta

OBJECTIVE: The objective of the study was to compare outcomes of women with placenta accreta who underwent cesarean hysterectomy with and without prophylactic intravascular balloon catheters. STUDY DESIGN: Case- control study of women at risk for placenta accreta identified using hospital databases and billing records from January 1995 to January 2006. Subjects with preoperative intravascular balloon catheter ( BC) placement plus hysterectomy were compared with those that had hysterectomy alone. RESULTS: Sixty- nine subjects had cesarean hysterectomy performed for placenta accreta; 19 subjects had balloon catheters plus hysterectomy and 50 subjects had hysterectomy alone. No significant differences were noted in estimated blood loss ( P =.79), transfused blood products ( P =.60), operative time ( P =.85), and postoperative hospital days ( P =.85). There were no significant differences in secondary outcomes between groups. Three of the 19 BC subjects ( 15.8%) had complications from catheter placement; 2 required stent placement and/ or arterial bypass. CONCLUSION: Prophylactic intravascular balloon catheters did not benefit women with placenta accreta undergoing cesarean hysterectomy.