Open versus endovascular REBOA control of blood loss during cesarean delivery in the placenta accreta spectrum: A single-center retrospective case control study.

Objective: The aim of this study was to compare two vascular control options for blood loss prevention and hysterectomy during cesarean delivery (CD): endovascular balloon occlusion of the aorta (REBOA) and open bilateral common iliac artery occlusion (CIAO) in women with extensive placenta accreta spectrum (PAS).

Study Design: This was retrospective comparison of cases of PAS using either CIAO (October 2017 through October 2018) or REBOA (November 2018 through November 2019) to prevent pathologic hemorrhage during scheduled CD. Women with confirmed placenta increta/percreta underwent either CD then intraoperative post-delivery, pre-hysterectomy open vascular control of both CIA (CIAO group) or pre-operative, ultrasound-guided, fluoroscopy-free REBOA followed by standard CD and balloon inflation after fetal delivery (REBOA group).