Department of Obstetrics, Chengdu Women's and Children's Central Hospital, Chengdu, China.
J Matern Fetal Neonatal Med. 2021 Jan;34(1):93-98. doi: 10.1080/14767058.2019.1599350. Epub 2019 Apr 9.
This study aimed to explore the therapeutic effectiveness of prophylactic internal iliac artery balloon occlusion (IIABO) during cesarean delivery in the management of patients with pernicious placenta previa (PPP) coexisting with placenta accreta (PA). This retrospectively study enrolled 83 patients diagnosed with PPP coexisting with PA in our hospital between January 2014 and December 2017. The patients were divided into the study group ( = 58, receiving routine cesarean section followed prophylactic IIABO) and control group ( = 25, receiving routine cesarean section alone). The general situation, intraoperative conditions, maternal and neonatal outcomes, and postoperative complications between the two groups were compared. The two groups were comparable due to no significant difference in the general situation of patients. The intraoperative conditions, such as intraoperative and postoperative blood loss, transfusion volume and the incidence rate of transfusion in the study group were significantly lower than those in the control group, but the incidence rate of disseminated intravascular coagulation and hysterectomy did not exhibit significant differences. Moreover, maternal and neonatal outcomes were not significantly different. Besides, in the study group, a patient with left foot numbness appeared left popliteal artery thrombosis and four patients experienced fever of <38.5 °C and lower abdominal pain. In the control group, a patient underwent hysterectomy. Prophylactic IIABO is an alternative method to control postpartum hemorrhage in the treatment of PPP coexisting with PA. However, it may not decrease the incidence of hysterectomy.
本研究旨在探讨剖宫产术中预防性子宫内动脉球囊阻断(IIABO)在凶险性前置胎盘(PPP)合并胎盘植入(PA)患者中的治疗效果。本回顾性研究纳入了 2014 年 1 月至 2017 年 12 月期间在我院诊断为 PPP 合并 PA 的 83 例患者。患者分为研究组( = 58,接受常规剖宫产术联合预防性 IIABO)和对照组( = 25,接受常规剖宫产术)。比较两组的一般情况、术中情况、母婴结局和术后并发症。由于患者的一般情况无显著差异,两组具有可比性。研究组的术中情况,如术中及术后出血量、输血量和输血发生率明显低于对照组,但弥散性血管内凝血和子宫切除术的发生率无显著差异。此外,母婴结局也无显著差异。此外,在研究组中,1 例患者出现左脚麻木,左腘动脉血栓形成,4 例患者出现<38.5℃发热和下腹痛。对照组中,1 例患者行子宫切除术。预防性 IIABO 是治疗 PPP 合并 PA 产后出血的一种替代方法,但不能降低子宫切除术的发生率。