Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, No. 1, East Jian She Road, Zhengzhou, 450052, Henan, People's Republic of China.
Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, No. 1, East Jian She Road, Zhengzhou, 450052, Henan, People's Republic of China.
Arch Gynecol Obstet. 2022 Oct;306(4):977-981. doi: 10.1007/s00404-021-06302-5. Epub 2022 Mar 23.
To evaluate the safety and efficacy of balloon occlusion at the Zone II aorta for the management of morbidly adherent placenta.
From September 2015 to October 2018, a total of 80 consecutive patients who were prenatally diagnosed with morbidly adherent placenta were assigned into two groups: the balloon occlusion group (n = 40) and the non-balloon occlusion group (n = 40).The intraoperative estimated blood loss, blood transfusion, urine output, serum creatinine, blood urea nitrogen and hysterectomy rate were recorded and compared between the two groups.
The estimated blood loss in the balloon occlusion group was significantly lower than that in the non-balloon occlusion group (811.75 ± 299.93 ml vs 1529.75 ± 808.01 ml, P < 0.001). The median amount of packed RBCs transfused in the balloon occlusion group and non-balloon occlusion group was 0 U and 2 U, respectively (P = 0.001). The women in the former group had a lower blood transfusion rate than those in the latter group (30% vs 57.5%, P = 0.013). Hysterectomy occurred in none in the balloon occlusion group but in six patients in the non-balloon occlusion group (P = 0.011).
The middle abdominal aorta (Zone II) is not a forbidden zone for occlusion as long as the single occlusion time is limited to 15 min. Balloon occlusion at the Zone II aorta can effectively reduce blood loss, transfusion requirements and hysterectomy rates in patients with morbidly adherent placenta.
评估在主动脉 II 区球囊阻断用于治疗凶险型前置胎盘的安全性和有效性。
2015 年 9 月至 2018 年 10 月，连续 80 例经产前诊断为凶险型前置胎盘的患者被分为两组：球囊阻断组（n = 40）和非球囊阻断组（n = 40）。记录并比较两组术中估计出血量、输血、尿量、血肌酐、血尿素氮和子宫切除率。
球囊阻断组术中估计出血量明显低于非球囊阻断组（811.75 ± 299.93ml 比 1529.75 ± 808.01ml，P < 0.001）。球囊阻断组和非球囊阻断组输注的浓缩红细胞中位数分别为 0U 和 2U（P = 0.001）。前者的输血率明显低于后者（30%比 57.5%，P = 0.013）。球囊阻断组无一例行子宫切除术，而非球囊阻断组有 6 例（P = 0.011）。
只要单次阻断时间限制在 15 分钟内，中腹部主动脉（II 区）不是一个禁止阻断的区域。在凶险型前置胎盘患者中，主动脉 II 区球囊阻断可有效减少出血量、输血需求和子宫切除术率。
