Prophylactic bilateral internal iliac arteries balloon occlusion in 13 patients of pernicious placenta previa with placenta accreta
10.3760/cma.j.issn.1007-9408.2013.08.005
- VernacularTitle:预防性双髂内动脉球囊闭塞术在13例凶险型前置胎盘伴胎盘植入患者中的应用效果
- Author:
Yanmin JIANG
;
Huishu LIU
;
Kunshan CHEN
- Publication Type:Journal Article
- Keywords:
Placenta previa;
Placenta accreta;
Iliac artery;
Embolization,therapeutic
- From:
Chinese Journal of Perinatal Medicine
2013;16(8):461-464
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the efficacy of prophylactic bilateral internal iliac arteries balloon occlusion in treatment of women with pernicious placenta previa complicated with placenta accreta.Methods A retrospective analysis was conducted on 41 cases of pernicious placenta previa with placenta accreta admitted to Guangzhou Women and Children's Medical Centre from January 2010 to December 2012.The study group (n=13) underwent prophylactic bilateral internal iliac arteries balloon placement before cesarean section and occlusion after delivery.The control group (n =28)received conventional haemostasis during cesarean section.The amount of blood loss and blood transfusion during the operation,the perioperative hemoglobin level,operation time and duration of hospitalization of the two groups were compared with t test or Chi square test.Results The volume of intraoperative hemorrhage of the study group was lower than of the control group [(1429±875) ml vs (4600± 2090) ml,t=6.840,P=0.000],the amount of intraoperative blood transfusion in the study group was also lower [(920±438) ml vs (3600± 1225) ml,t=10.251,P=0.000].Operation time and postoperative duration of hospitalization of the study group were shorter than those of the control group [(197±45) min vs (284±44) min,t 5.850,P=0.000; (6.7±1.3) d vs (8.2± 2.2) d,t=2.272,P=0.029].There was no statistical difference on hysterectomy rate between the two groups [11/13 vs 89%(25/28),x2=0.181,P 0.670)].In addition,two cases of reoperation,one case of pulmonary edema,two cases of coagulation disorder,one case of venous thrombosis in lower limbs,one case of renal dysfunction and pulmonary edema were reported in the control group,but none in the study group.Conclusions.Prophylactic bilateral internal iliac arteries balloon occlusion is effective in reducing intraoperative blood loss,transfusion,and relative complications in patients with pernicious placenta previa complicated with placenta accreta.