Cesarean Section and Total Hysterectomy Considering Use of Bilateral Internal Iliac Arterial Occlusion Balloon for Placenta Percreta：A Case Report

Abstract

We report a case in which an emergency cesarean section and hysterectomy were safely performed after the insertion of an arterial occlusion balloon（OB）in a woman with placenta percreta after premature rupture of the membrane. The patient was a woman in her 30s. Her water broke at 27 weeks and 4 days of pregnancy, and she was rushed to hospital. Close examination revealed a placenta percreta. The following day, a cesarean section was performed under a combined spinal-epidural anesthesia with OB, followed by induction of general anesthesia and a total hysterectomy. Hemorrhage was 4,000 mL including urine and amniotic fluid, but the intraoperative hemodynamics were stable and the postoperative course was good. Placenta percreta carries a high risk of massive hemorrhage, so how to respond to such an event and the method of anesthesia to be used should be considered in the managing of such cases.