Department of Obstetrics and Gynecology, Chengdu Women and Children's Central Hospital Affiliated to University of Electronic Science and Technology of China, Chengdu, 1617 Riyue Avenue, Qingyang District, Sichuan Province, China.
Department of Obstetrics and Gynecology, Chengdu Women and Children's Central Hospital Affiliated to University of Electronic Science and Technology of China, Chengdu, 1617 Riyue Avenue, Qingyang District, Sichuan Province, China.
Eur J Radiol. 2021 Jun;139:109711. doi: 10.1016/j.ejrad.2021.109711. Epub 2021 Apr 20.
To examine the effectiveness and safety of prophylactic internal iliac artery balloon occlusion for hemorrhage control in placenta accreta.
EMBASE, PubMed, and the Cochrane Central Register of Controlled Trials data-bases were searched through November 2020. Clinical trials comparing the management of placenta accreta with and without internal iliac artery balloon occlusion were included. The meta-analysis results were expressed as the risk ratio (RR) or mean difference, with 95 % CIs.
Fifteen studies including 1098 women were eligible. No statistically significant difference was found between the internal arterial balloon occlusion group and the control group with respect to estimated blood loss volume (-0.525 mL, [95 % CI, -1.112 to -0.061], p = 0.079.), red blood cells (RBCs) transfused in observational studies (-0.682 mL, [95 % CI, -1.540 to 0.176], p = 0.119.) and in randomized controlled trials (0.134 mL, [95 % CI, -0.214 to 0.482], p = 0.451.), intensive care unit admission (p = 0.197), hysterectomy in observational studies (p = 0.969) and in randomized controlled trials (p = 0.323), urinary system injury in observational studies (p = 0.182) and in randomized controlled trials (p = 0.956), Apgar score at 5 min (p = 0.641), and neonatal intensive care unit admission (p = 0.973).
The currently available data demonstrate no significant differences between the internal iliac artery balloon occlusion group and the control group in blood loss and packed RBCs transfused for women with placenta accreta. Further large randomized controlled studies are needed to confirm our findings.
探讨预防性子宫动脉球囊阻断术在控制胎盘植入性出血中的有效性和安全性。
检索 EMBASE、PubMed 和 Cochrane 中央对照试验数据库，检索时间截至 2020 年 11 月。纳入比较胎盘植入患者采用和不采用子宫动脉球囊阻断术治疗的临床试验。Meta 分析结果表示为风险比（RR）或均数差，95%置信区间（CI）。
纳入 15 项研究，共 1098 名女性。与对照组相比，子宫动脉球囊阻断组的估计出血量（-0.525 mL，95%CI：-1.112 至 -0.061，p = 0.079）、观察性研究中输注的红细胞（RBC）（-0.682 mL，95%CI：-1.540 至 0.176，p = 0.119）和随机对照试验中（0.134 mL，95%CI：-0.214 至 0.482，p = 0.451）、重症监护病房收治率（p = 0.197）、观察性研究中子宫切除术（p = 0.969）和随机对照试验中（p = 0.323）、观察性研究中泌尿系统损伤（p = 0.182）和随机对照试验中（p = 0.956）、5 分钟时的 Apgar 评分（p = 0.641）和新生儿重症监护病房收治率（p = 0.973）差异均无统计学意义。
目前的数据表明，在胎盘植入性出血患者中，子宫动脉球囊阻断组与对照组在失血量和输注红细胞方面无显著差异。需要进一步进行大型随机对照研究来证实我们的发现。
