Comment on “Discussion on the Timing of Balloon Occlusion of the Abdominal Aorta during a Caesarean Section in Patients with Pernicious Placenta Previa Complicated with Placenta Accreta”

الملخص EN

The drier the surgical field, the better: this holds true for every surgery.

The treatment of abnormally invasive placenta (AIP: accreta, increta, percreta) is still challenging, and aortic balloon occlusion (ABO) has attracted obstetricians’ attention: it may reduce bleeding during surgery.

Zhu et al.

[1] demonstrated interesting data.

In presurgically suspected AIP patients with the placenta covering the previous cesarean scar, perinatal outcomes were compared between two strategies: ABO performed “before” versus “after” infant delivery.

Bleeding during surgery was significantly reduced “before” compared with “after” (413 versus 810 mL, respectively) with no difference in the neonatal outcomes.

Based on these data, Zhu et al.

concluded that ABO “before” uterine incision is better than “after” it.

I have some clarifications and concerns.