TeMpOH-3

Major obstetric haemorrhage (MOH) is worldwide the most important cause of severe maternal morbidity and mortality. Abnormally invasive placenta (AIP), covers placenta accreta, increta and percreta, and is considered as a severe pregnancy complication that is frequently associated with major and potentially life threatening postpartum haemorrhage. The most important risk factors for AIP include advanced maternal age, placenta praevia and previous caesarean sections or other uterine surgeries.
Prophylactic placement of catheters for intraoperative balloon occlusion or embolisation of the internal iliac artery in patients at high risk of AIP may prevent the occurrence of MOH. However, this technique is not routinely performed as there is currently too scarce evidence addressing its benefits and risks.

Objectives: To assess the effect of preoperative, prophylactic arterial catheterization on the occurrence of MOH and its sequelae in patients at high risk of AIP who undergo an elective caesarean delivery, compared to omission of this intervention.

Study design: Nationwide, retrospective cohort study.

Study population: This cohort study will be carried out in patients at high risk of abnormally invasive placenta who underwent an elective caesarean delivery between January 2008 and January 2013 in the Netherlands.
Abnormally invasive placenta covers placenta accreta, increta and percreta. In our study, women with a placenta praevia, in combination with at least one previous caesarean section, are considered as patients at high risk of AIP.

Prophylactic radiological interventions do prevent major obstetric haemorrhage in patients at high risk of abnormally invasive placenta

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Profylactic radiological interventions.