The Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, Chongqing Medical University, Chongqing, 400016, China.
BMC Pregnancy Childbirth. 2019 Jan 15;19(1):30. doi: 10.1186/s12884-019-2175-0.
Severe obstetric hemorrhage caused by placenta accreta results in significant maternal morbidity and mortality. As a new technology, abdominal aortic balloon occlusion (AABO) is becoming an important treatment for patients with placenta accreta. To evaluate the safety and efficacy of AABO, we conducted a systematic review and meta-analysis of previous studies.
We used a three-check subset including placenta accreta (placenta previa, percreta, increta, etc.), balloon, and aortic (aortas, aorta, etc.) to form a retrieval formula and searched in MEDLINE, EMBASE, the Cochrane Library, clinicaltrials.gov and Web of Science. All articles regarding placenta previa or placenta accreta and including the use of abdominal aortic balloon occlusion were included in our screening. Two researchers selected articles and extracted data independently. Finally, the Newcastle-Ottawa Quality Assessment Scale was used for quality assessments.
We retrieved 776 articles and eventually included 11 clinical studies. Meta-analysis showed that AABO significantly reduced the blood loss volume (MD - 1480 ml, 95% CI -1806 to - 1154 ml, P < 0.001) and blood transfusion volume (MD - 1125 ml, 95% CI -1264 to - 987 ml, P < 0.001). Similarly, obvious reductions in the hysterectomy rate (OR 0.30, 95% CI 0.19 to 0.48, P < 0.001), hospitalization duration (MD - 1.35 days, 95% CI -2.40 to - 0.31 days, P = 0.01), and operative time (MD - 29.23 min, 95% CI -46.04 to - 12.42 min, P < 0.001) were observed in the AABO group.
The prophylactic use of AABO in patients with placenta accreta is safe and effective.
胎盘植入导致的严重产科出血会导致产妇发病率和死亡率显著增加。作为一种新技术，腹主动脉球囊阻断（AABO）正成为胎盘植入患者的重要治疗手段。为了评估 AABO 的安全性和疗效，我们对以往的研究进行了系统评价和荟萃分析。
我们使用包括胎盘植入（前置胎盘、穿透性胎盘、植入性胎盘等）、球囊和主动脉（主动脉、主动脉等）的三检查子集来形成检索公式，并在 MEDLINE、EMBASE、Cochrane 图书馆、clinicaltrials.gov 和 Web of Science 中进行检索。我们的筛选包括所有关于前置胎盘或胎盘植入并包括使用腹主动脉球囊阻断的文章。两名研究人员独立选择文章并提取数据。最后，使用纽卡斯尔-渥太华质量评估量表进行质量评估。
我们检索到 776 篇文章，最终纳入 11 项临床研究。荟萃分析显示，AABO 显著减少了出血量（MD-1480ml，95%CI-1806 至-1154ml，P<0.001）和输血量（MD-1125ml，95%CI-1264 至-987ml，P<0.001）。同样，AABO 组的子宫切除术率（OR 0.30，95%CI 0.19 至 0.48，P<0.001）、住院时间（MD-1.35 天，95%CI-2.40 至-0.31 天，P=0.01）和手术时间（MD-29.23 分钟，95%CI-46.04 至-12.42 分钟，P<0.001）明显降低。
在胎盘植入患者中预防性使用 AABO 是安全有效的。
