Qiu Zhongyuan, Hu Jifen, Wu Jianbo, Chen Lihong
aObstectic & Gynecology, Fujian Medical University Union Hospital bObstectic & Gynecology, the Third Affiliated Hospital of Fujian Medical University cObstetrics & Gynecology, the First Affiliated Hospital of Fujian Medical University, China.
Medicine (Baltimore). 2017 Nov;96(46):e8681. doi: 10.1097/MD.0000000000008681.
To evaluate the clinical efficacy of prophylactic temporary balloon occlusion of the abdominal aorta in patients with placenta previa accretism during cesarean section.
Twenty-three consecutive patients, prenatally confirmed with placenta previa accretism were retrospectively analyzed in our center from August 2012 to October 2014. All 23 subjects underwent cesarean section with prophylactic balloon occlusion of the abdominal aorta.
All of the 23 subjects experienced singleton pregnancies leading to the birth of live infants. Of these subjects, the following problems were diagnosed: placenta accrete (n = 10), placenta increte (n = 10), and placenta precrete (n = 3). Mean intraoperative hemorrhage was 1170.0 mL. Fifteen patients received red blood cell transfusion with a mean transfusion volume of 2.3 units. The incidence of hysterectomy was 21.74% (5/23) with blood loss ranging from 2000 to 5000 mL (mean 3360.0 mL). One complication encountered in this retrospective study was lower extremity arterial thrombosis. Eighteen patients were followed-up by telephone to 14 months following discharge, all babies were noted to be healthy.
Prophylactic abdominal aorta balloon occlusion (ABO) was relatively safe in the treatment of patients with placenta previa accretism. This approach could represent a key aspect in a multidisciplinary algorithm in reducing hemorrhage in abnormal placentation.
评估剖宫产术中预防性临时球囊阻断腹主动脉在凶险性前置胎盘中的临床疗效。
回顾性分析2012年8月至2014年10月在本中心连续收治的23例产前确诊为凶险性前置胎盘的患者。所有23例患者均在剖宫产术中行预防性腹主动脉球囊阻断术。
23例患者均为单胎妊娠并分娩活婴。这些患者中，诊断出以下情况：粘连性胎盘（n = 10）、植入性胎盘（n = 10）和穿透性胎盘（n = 3）。术中平均出血量为1170.0毫升。15例患者接受了红细胞输血，平均输血量为2.3单位。子宫切除发生率为21.74%（5/23），失血量在2000至5000毫升之间（平均3360.0毫升）。本回顾性研究中遇到的一种并发症是下肢动脉血栓形成。18例患者在出院后通过电话随访至14个月，所有婴儿均健康。
预防性腹主动脉球囊阻断术（ABO）在凶险性前置胎盘患者的治疗中相对安全。这种方法可能是多学科方案中减少胎盘植入异常出血的关键环节。
