Intra-abdominal aortic balloon occlusion in the management of placenta percreta.
10.1097/CM9.0000000000001944
- Author:
Weiran ZHENG
1
;
Ruochong DOU
1
;
Jie YAN
1
;
Xinrui YANG
1
;
Xianlan ZHAO
2
;
Dunjin CHEN
3
;
Yuyan MA
4
;
Weishe ZHANG
5
;
Yiling DING
6
;
Ling FAN
7
;
Huixia YANG
1
Author Information
1. Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing Key Laboratory of Maternal-Fetal Medicine of Gestational Diabetes Mellitus, Xicheng District, Beijing 100034, China.
2. Department of Obstetrics and Gynecology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, China.
3. Department of Obstetrics and Gynecology, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510260, China.
4. Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Jinan, Shandong 250012, China.
5. Department of Obstetrics and Gynecology, Xiangya Hospital Central South University, Changsha, Hunan 410008, China.
6. Department of Obstetrics and Gynecology, Second Xiangya Hospital of Central South University, Changsha, Hunan 410008, China.
7. Department of Obstetrics and Gynecology, Beijing Obstetrics and Gynecology Hospital, Beijing 100026, China.
- Publication Type:Journal Article
- MeSH:
Aorta;
Balloon Occlusion/methods*;
Blood Loss, Surgical;
Female;
Humans;
Hysterectomy;
Infant, Newborn;
Placenta Accreta/surgery*;
Placenta Previa/surgery*;
Postpartum Hemorrhage;
Pregnancy;
Retrospective Studies
- From:
Chinese Medical Journal
2022;135(4):441-446
- CountryChina
- Language:English
-
Abstract:
BACKGROUND:Massive bleeding is the main concern for the management of placenta percreta (PP). Intra-abdominal aortic balloon occlusion (IABO) is one method for pelvic devascularization, but the efficacy of IABO is uncertain. This study aims to investigate the outcomes of IABO in PP patients.
METHODS:We retrospectively reviewed the clinical data of PP cases from six tertiary centers in China between January 2011 and December 2015. PP cases with/without the use of IABO were analyzed. Propensity score matching analysis was performed to reduce the effect of selection bias. Postpartum hemorrhage (PPH) and the rate of hysterectomy, as well as neonatal outcomes, were analyzed.
RESULTS:One hundred and thirty-two matched pairs of patients were included in the final analysis. Compared with the control group, maternal outcomes, including PPH (68.9% vs. 87.9%, χ2 = 13.984, P < 0.001), hysterectomy (8.3% vs. 65.2%, χ2 = 91.672, P < 0.001), and repeated surgery (1.5% vs. 12.1%, χ2 = 11.686, P = 0.001) were significantly reduced in the IABO group. For neonatal outcomes, Apgar scores at 1 minute (8.67 ± 1.79 vs. 8.53 ± 1.68, t = -0.638, P = 0.947) and 5 minutes (9.43 ± 1.55 vs. 9.53 ± 1.26, t = 0.566, P = 0.293) were not significantly different between the two groups.
CONCLUSIONS:IABO can significantly reduce blood loss, hysterectomies, and repeated surgeries. This procedure has not shown harmful effects on neonatal outcomes.
