Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang 110004, China.
Key Laboratory of Maternal-Fetal Medicine of Liaoning Province and Key Laboratory of Obstetrics and Gynecology of Higher Education of Liaoning Province, Benxi 117000, China.
Biomed Res Int. 2018 Jun 6;2018:4596189. doi: 10.1155/2018/4596189. eCollection 2018.
To evaluate the efficacy and safety of prophylactic balloon occlusion of the infrarenal abdominal aorta in pernicious placenta previa coexisting with placenta accrete.
This retrospective study was performed in patients with placenta accreta complicated with pernicious placenta previa between January 2014 and December 2016 in Shengjing Hospital; 56 patients with a pathological diagnosis were included. The degree of placental invasion was evaluated by preoperative color Doppler ultrasonography and/or magnetic resonance imaging, and all patients in this study should undergo balloon occlusion preoperatively, which was a determination made by specific doctors. The control group consisted of 32 patients who underwent cesarean section alone, and the study group included 24 patients who underwent cesarean section with preoperative balloon occlusion. Prevention of hysterectomy was the primary outcome evaluated. The secondary outcomes include operative duration, estimated blood loss, blood transfusion, prothrombin time postoperatively, decrease in the hemoglobin level postoperatively, intensive care unit admission, pathological diagnosis, and total hospital stay (days), and these data were compared between the two groups. Additionally, the neonatal outcomes, premature delivery, Apgar scores at 1 minute and 5 minutes, neonatal birth weight, hospitalization, and mortality were compared.
There was a significant difference in the rate of hysterectomy between the two groups (<0.05). However, no differences were observed between the groups in any other outcomes.
The prophylactic use of infrarenal abdominal aortic balloon occlusion is an effective and safe option for treating pernicious placenta previa coexisting with placenta accreta.
评估预防性阻断腹主动脉下段在凶险性前置胎盘合并胎盘植入中的疗效及安全性。
本回顾性研究纳入 2014 年 1 月至 2016 年 12 月在盛京医院就诊的胎盘植入合并凶险性前置胎盘患者，共 56 例，均经病理诊断证实。所有患者均经术前彩色多普勒超声和/或磁共振成像评估胎盘植入程度，本研究中所有患者均行术前球囊阻断，这是由特定医生决定的。对照组为单纯行剖宫产术的 32 例患者，研究组为行剖宫产术+术前球囊阻断的 24 例患者。预防子宫切除术是评估的主要结局。次要结局包括手术时间、估计失血量、输血、术后凝血酶原时间、术后血红蛋白水平下降、入住重症监护病房、病理诊断和总住院天数（天），并比较两组之间的这些数据。此外，还比较了两组新生儿结局、早产、1 分钟和 5 分钟时的 Apgar 评分、新生儿出生体重、住院时间和死亡率。
两组子宫切除术率差异有统计学意义（<0.05）。然而，两组在其他任何结局方面均无差异。
预防性使用腹主动脉下段球囊阻断术治疗凶险性前置胎盘合并胎盘植入是一种有效且安全的选择。
