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STUDY PROTOCOL article

Front. Med.
Sec. Obstetrics and Gynecology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1535258

Effectiveness of Aortic Balloon Occlusion in Reducing Blood Loss During Cesarean Section in Placenta Accreta Spectrum Disorders: A Study Protocol for Randomized Controlled Trial

Provisionally accepted
Gauri Bapayeva Gauri Bapayeva 1Gulzhanat Aimagambetova Gulzhanat Aimagambetova 2*Nazira Kadroldinova Nazira Kadroldinova 2Viktor Zemlyanskiy Viktor Zemlyanskiy 1Kuat Kassymbek Kuat Kassymbek 1Milan Terzic Milan Terzic 2
  • 1 University Medical Center Astana, Nur-sultan, Kazakhstan
  • 2 School of Medicine, Nazarbayev University, Nur-sultan, Kazakhstan

The final, formatted version of the article will be published soon.

    Introduction: Obstetric hemorrhage is one of the leading causes of maternal mortality and morbidity worldwide. One of the major risk factors of obstetric hemorrhage include placenta previa and placenta accreta spectrum (PAS) disorders. The frequency of PAS disorders is increasing worldwide and is accompanied by intraoperative massive bleeding with hemorrhagic shock and increasing rates of cesarean hysterectomy. To decrease the risks of bleeding, various approaches of endovascular balloon occlusion have been tested during the recent decade. Objectives: This study aims to evaluate the effectiveness of resuscitative endovascular balloon occlusion of the aorta (REBOA) in reducing blood loss and preserving the reproductive organs during cesarean section. Study design: This will be a prospective randomized controlled trial involving 144 patients in a tertiary care obstetric center in Kazakhstan. The study population will consist of pregnant women who will be admitted for cesarean section due to placenta previa complicated by PAS disorders. Study subjects will be randomly divided into intervention and control groups. Results: The results will be analyzed through the measurement of primary (blood loss during cesarean section) and secondary outcomes [occurrence of hysterectomy during cesarean section, blood transfusion volume, duration of surgery, balloon application time, stay in intensive care unit (ICU), neonatal outcomes, complications, and total days of postsurgical hospital stay]. Conclusion: The use of REBOA is expected to minimize intraoperative blood loss during cesarean section, decrease the need for transfusion of blood components, reduce the time of surgical intervention, decrease the rate of maternal complications, and reduce the rate of cesarean hysterectomy

    Keywords: Obstetric hemorrhage, Abnormally invasive placenta, Endovascular balloon occlusion, Cesarean Section, REBOA, clinical outcome, Cesarean hysterectomy, Placenta accreta spectrum

    Received: 27 Nov 2024; Accepted: 24 Jan 2025.

    Copyright: © 2025 Bapayeva, Aimagambetova, Kadroldinova, Zemlyanskiy, Kassymbek and Terzic. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Gulzhanat Aimagambetova, School of Medicine, Nazarbayev University, Nur-sultan, 010000, Kazakhstan

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.