Anaesthetic strategies for managing placenta accreta spectrum with resuscitative endovascular balloon occlusion of the aorta (REBOA): Insights from an international multicentre retrospective study
Authors' conclusion
Ultrasound-guided REBOA placement appears to significantly reduce procedural time.
Study context
- Population
- Patients with placenta accreta spectrum (PAS) undergoing caesarean delivery with REBOA placement, 4 tertiary centres in Israel and Spain, January 2019–December 2023
- Participants
- 47 patients · 4 centres
- Outcome
- Anaesthetic management and outcomes of PAS patients undergoing caesarean delivery with REBOA
Methodological detailsinternational, multicentre
- International
- Multicentre
Main finding
As reported in the abstract
Anaesthetic management
- Initial anaesthesia neuraxial
- 85.1%
- Initial anaesthesia CSE
- 46.8%
- Conversion to GA among neuraxial cases
- 52.5%
- Reason for conversion: pain
- 52.4%
- Reason for conversion: surgeon request
- 42.9%
Observational data: associations, not effects.
Secondary outcomes
Anaesthesia-to-delivery interval, ultrasound- vs fluoroscopy-guided REBOA placement · significantly shorter with ultrasound
P = 0.003
- Anaesthesia-to-delivery interval, ultrasound- vs fluoroscopy-guided REBOA placement — REBOA placed under ultrasound guidance
- 57.4%
REBOA inflation
- REBOA placed in all cases but inflated
- 76.6%
Estimated blood loss
- Median estimated blood loss, l [0.9 to 2.5]
- 1.5
Hysterectomy and ICU admission
- Hysterectomy performed
- 57.4%
- Required ICU admission
- 31.9%
Neonatal outcomes
- Median Apgar score at both one and five minutes
- 9.0
Safety
- REBOA-related complications (minimal)
- 4.3%
Original publication
Anaesthetic strategies for managing placenta accreta spectrum with REBOA: Insights from an international multicentre retrospective study. Eur J Anaesthesiol. Published 5 June 2025. doi:10.
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