Abstract
Background: The proper management of placenta accreta remains challenging, with risks of significant blood loss. Interventional radiology assistance for control of hemorrhage is considered for difficult cases however this involves transportation of a critically ill patient. Case: We performed a multi-step cesarean hysterectomy for placenta accreta in a hybrid operating room suite. With intra-arterial catheters placed pre-operatively, the cesarean was performed leaving the placenta in utero, with intra-operative pelvic artery embolization followed by completion of the hysterectomy. The total estimated blood loss was 1100mL. Conclusion: Single location cesarean section with pelvic artery embolization in a hybrid operating room was associated with significantly less blood loss. Larger case series of staged single location cesarean hysterectomy for placenta accreta variants would be required to confirm the overall improved outcomes.
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