Outcome of Pregnancies After Balloon Occlusion of the Infrarenal Abdominal Aorta During Caesarean in 230 Patients With Placenta Praevia Accreta

• Published in: Cardiovascular and interventional radiology 2016-11, Vol.39 (11), p.1573-1579
• Main Authors: Wu, Qinghua, Liu, Zhuan, Zhao, Xianlan, Liu, Cai, Wang, Yanli, Chu, Qinjun, Wang, Xiaojuan, Chen, Zhimin
• Format: Article
• Language: English
• Subjects: Adult; AORTA; Aorta, Abdominal; Balloon Occlusion - methods; BALLOONS; BLOOD; Blood Loss, Surgical - prevention & control; Blood Transfusion; Cardiology; Cesarean Section; Clinical Investigation; COMPARATIVE EVALUATIONS; Female; HAZARDS; HEMORRHAGE; HOSPITALS; Humans; Hysterectomy; Imaging; Infant, Newborn; Medicine; Medicine & Public Health; Nuclear Medicine; PATIENTS; PLACENTA; Placenta Accreta - surgery; Placenta Previa - surgery; Postoperative Complications - etiology; Postoperative Complications - prevention & control; Postpartum Hemorrhage - prevention & control; PREGNANCY; PROTHROMBIN; Radiology; RADIOLOGY AND NUCLEAR MEDICINE; Retrospective Studies; REVIEWS; SURGERY; TRANSFUSIONS; Treatment Outcome; Ultrasound; VASCULAR DISEASES
• ISSN: 0174-1551; 1432-086X
• DOI: 10.1007/s00270-016-1418-y

Purpose To explore the efficacy and safety of prophylactic temporary balloon occlusion of the infrarenal abdominal aorta during caesarean for the management of patients with placenta praevia accreta. Methods Two hundred and sixty-eight cases of placenta praevia accreta from January 2012 to June 2015 were retrospectively reviewed. Group A included two hundred and thirty patients who underwent prophylactic temporary balloon occlusion of infrarenal abdominal aorta followed by caesarean section. Group B included thirty-eight patients who underwent caesarean without endovascular intervention. The parameters including operating room time, estimated blood loss, blood transfusion volume, PT (prothrombin time) during operation, days in the intensive care unit, and total hospital days were compared between the two groups. Results The operating room time, estimated blood loss, PT, the incidence of hysterectomy, blood transfusion volume, postpartum haemorrhage, and days in intensive care unit were lower in group A than in group B, with statistical significance ( P   0.05). No patient in the group with prophylactic temporary balloon occlusion of the infrarenal abdominal aorta was performed hysterectomy, while three patients in group B were performed hysterectomy because of uncontrollable haemorrhage. Conclusions The results indicate that prophylactic temporary balloon occlusion of infrarenal abdominal aorta followed by caesarean section is safe and effective to control intraoperative blood loss and greatly decreases the risk of hysterectomy in patients with placenta praevia accreta.