Placental Adhesion Subsequent to Uterine Preservation via Resuscitative Endovascular Balloon Occlusion of the Aorta: A Case Report.

An adherent placenta is a life-threatening condition that impairs the mother's life owing to hemorrhagic shock and disseminated intravascular coagulation. Profound hemorrhage resulting from placental abruption is often managed using hysterectomy to preserve the mother's life, although the consequent loss of fertility can be devastating, particularly in younger women. Thus, strategies that facilitate fertility preservation while effectively controlling hemorrhage should be considered viable alternatives. Resuscitative endovascular balloon occlusion of the aorta (REBOA) is commonly performed in patients experiencing traumatic hemorrhagic shock; however, its application in obstetric cases remains infrequent. Herein, we report a case in which REBOA was used to control hemorrhage following the manual removal of an adherent placenta, with the aim of preserving the uterus. A 28-year-old woman presented to our hospital with hemorrhagic shock owing to extensive bleeding from an adherent placenta. As the patient was a young, primiparous woman with a strong desire to preserve her uterus, we opted for manual placental removal. However, manual removal poses a risk of exacerbating the hemorrhage. Therefore, REBOA was performed by emergency physicians to reduce bleeding during placental abruption, and intrauterine balloon tamponade was used to achieve hemostasis without compromising the patient's condition. The use of REBOA in the management of placenta accreta not only improves survival rates but may also provide crucial time for fertility-preserving interventions.