Temporary Clamping of Bilateral Common Iliac Artery During Cesarean Hysterectomy for the Management of Placenta Percreta.

OBJECTIVE

To evaluate whether bilateral common iliac artery (CIA) temporary clamping reduces blood loss during cesarean-hysterectomy of placenta percreta cases.

STUDY

DESIGN

A total of 32 women, who underwent cesarean-hysterectomy under bilateral CIA temporary clamping (n = 12) and without any arterial clamping or ligation (control group, n = 20) due to placenta percreta in Gaziantep University Hospital were retrospectively evaluated. The intra- and postoperative outcomes such as blood loss, blood transfusion and complications were compared between the two groups.

RESULTS

Age, parity, body-mass-index and gestational-age were similar in the two groups. The estimated blood loss was lower in the temporary clamping of CIA group than the control group (595 ± 172 mL vs 1450 ± 662 mL, P < 0.001). The number of intraoperative packed-red-blood-cells (0.17 ± 0.58 units vs 1.85 ± 1.46 units, P = 0.002) and fresh-frozen-plasma (0.17 ± 0.58 units vs 1.7 ± 1.49 units, P = 0.005) transfusions were lower in the CIA temporary clamping group than the control group. The rate of women, who received blood/blood products were significantly lower in the CIA temporary clamping group compared to the control group (75 % vs 16 %, P = 0.001). Duration of operation was longer in the CIA temporary clamping group (140 ± 38 min vs 90 ± 25 min, p = 0.001). No complication or maternal death was encountered during this study.

CONCLUSION

Bilateral CIA temporary clamping method reduces the intraoperative blood loss and the amount of intraoperative blood/blood product transfusions during cesarean-hysterectomy due to placenta percreta.