Resuscitative endovascular balloon occlusion of the aorta deployed by acute care surgeons in patients with morbidly adherent placenta: a feasible solution for two lives in peril |
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| Authors: | Ramiro Manzano-Nunez Maria F Escobar-Vidarte Claudia P Orlas Juan P Herrera-Escobar Samuel M Galvagno Juan J Melendez Natalia Padilla Justin C McCarty Albaro J Nieto Carlos A Ordoñez |
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| Institution: | 1.Clinical Research Center,Fundacion Valle del Lili,Cali,Colombia;2.Center for Surgery and Public Health - Brigham and Women’s Hospital,Harvard Medical School & Harvard T.H. Chan School of Public Health,Boston,USA;3.Trauma and Acute Care Surgery Division, Department of Surgery,Fundacion Valle del Lili,Cali,Colombia;4.R. Adams Cowley Shock Trauma Center,Baltimore,USA;5.Trauma Division and Trauma and Emergency Surgery Fellowship,Universidad del Valle,Cali,Colombia;6.Critical Care Obstetrics, Department of Gynecology and Obstetrics,Fundacion Valle del Lili,Cali,Colombia;7.School of Medicine,Universidad ICESI,Cali,Colombia |
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| Abstract: | Morbidly adherent placenta (MAP), which includes accreta, increta, and percreta, is a condition characterized by the invasion of the uterine wall by placental tissue. The condition is associated with higher odds of massive post-partum hemorrhage. Several interventions have been developed to improve hemorrhage-related outcomes in these patients; however, there is no evidence to prefer any intervention over another. Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an endovascular intervention that may be useful and effective to reduce hemorrhage and transfusions in MAP patients. The objective of this narrative review is to summarize the evidence for REBOA in patients with MAP. We posit that acute care surgeons can perform REBOA for patients with MAP. |
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