Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy.
Department of Obstetrics and Gynaecology, Umberto I Hospital, Enna, Italy.
Arch Gynecol Obstet. 2018 Jul;298(1):83-88. doi: 10.1007/s00404-018-4780-y. Epub 2018 May 18.
We studied the efficacy of using pre-cesarean delivery (CD) temporary occlusion of internal iliac arteries with balloon catheters in case of placenta previa-accreta in terms of maternal and neonatal outcomes and to test accuracy of ultrasound (US) and magnetic resonance imaging (MRI) for prenatal diagnosis.
From March 2014 to January 2018, women with an US and/or MRI diagnosis of placenta previa-accreta and a planned delivery were enrolled and divided into two groups: balloon catheterization group (women treated with preoperative catheters and CD) and control group (women candidates to elective CD).
37 patients were enrolled: 16 in balloon catheterization group and 21 in control group. Significant differences were detected in estimated blood loss. Prophylactic balloon catheterization could reduce intraoperative red blood cell transfusion. The incidence of hysterectomy was lower in balloon group. No statistical difference was found for neonatal outcomes. Both US and MRI have showed to be useful and complementary to diagnose placenta previa-accreta.
Temporal, perioperative, and prophylactic positioning of balloon vascular catheters is an effective method for managing severe hemorrhage caused by placenta previa-accreta as it reduced intraoperative blood loss, lessened perioperative hemostatic measures and intraoperative red cell transfusions, and reduced hysterectomies.
我们研究了在前置胎盘-胎盘植入的情况下，使用球囊导管在剖宫产术前暂时阻断髂内动脉的疗效，以评估其对母婴结局的影响，并测试超声（US）和磁共振成像（MRI）在产前诊断中的准确性。
自 2014 年 3 月至 2018 年 1 月，我们招募了超声和/或 MRI 诊断为前置胎盘-胎盘植入且计划分娩的妇女，并将其分为两组：球囊导管组（术前放置导管和剖宫产）和对照组（择期剖宫产）。
共纳入 37 例患者：球囊导管组 16 例，对照组 21 例。两组在估计失血量方面存在显著差异。预防性球囊导管置入可减少术中红细胞输注。球囊组的子宫切除术发生率较低。新生儿结局无统计学差异。US 和 MRI 均显示对诊断前置胎盘-胎盘植入具有有用性和互补性。
临时、围手术期和预防性放置球囊血管导管是治疗前置胎盘-胎盘植入严重出血的有效方法，可减少术中失血量、减少围手术期止血措施和术中红细胞输注，并降低子宫切除术的发生率。
