Two complications of pregnancy can cause life-threatening hemorrhage: placenta previa and placenta accreta. In addition to controlling a potentially fatal hemorrhage, the procedure can avoid a hysterectomy to control the bleeding. With placenta previa, the placenta covers a portion or even all of the cervix; thus, when it begins to dilate, hemorrhage occurs. Placenta accreta is a condition in which the placenta is densely adherent to the uterus, and hemorrhage occurs when it dislodges. A radiologic procedure that involves inflating a balloon in the arteries that supply the uterus can effectively and safely treat both conditions. Researchers at Cork University Hospital in Ireland reported the results of a study of the devic at the annual Radiological Society of North America conference in Chicago, Illinois.
According to the American Congress of Obstetricians and Gynecologists, both conditions are on the rise, and this increase may be attributable to uterine scarring following a cesarean section. Placenta previa currently complicates approximately 1 if 200 pregnancies. For the period of 1982 through 200s, the incidence of placenta accreta was 1 in 533 pregnancies. This figure contrasts sharply with previous reports, which ranged from 1 in 4,027 pregnancies in the 1970s, increasing to 1 in 2,510 pregnancies in the 1980s. Both conditions can be diagnosed during pregnancy with an ultrasound examination, which is commonly performed during a pregnancy. Thus, plans can be made for a cesarean section when the pregnancy reaches full term or bleeding occurs; however, not uncommonly, hemorrhage requires an emergency cesarean.
The study group comprised 22 women; 13 had a placenta previa, and 9 had a placenta accreta. A small balloon was fed into the arteries that supply the uterus. The balloons were inserted fully deflated, but could be promptly inflated to temporarily stop blood flow if hemorrhage occurred. All the subjects underwent a scheduled cesarean section. More than half (7 with placenta previa and 6 with placenta accreta) began to hemorrhage during the operation. The balloons were inflated in these women; in 11 cases, the balloons controlled the bleeding long enough for the surgeons to locate the sources of bleeding in the uterus and suture them. After suturing, the balloons were deflated. The procedure did not control the bleeding in two women with placenta accreta, and they underwent a hysterectomy. None of the patients suffered any other complications and all the infants were healthy.
