Fashafsheh Nawras, Elhaty Ismail A
Arab American University, Faculty of Nursing, Child Health and Disease Department, Palestine, Palestine.
Department of Child Health and Diseases Nursing, Faculty of Health Sciences, Nursing, Istanbul Gelisim University, Istanbul, Turkey.
SAGE Open Nurs. 2025 May 13;11:23779608251342751. doi: 10.1177/23779608251342751. eCollection 2025 Jan-Dec.
Placenta accreta spectrum (PAS) disorders have become more noticeable as a serious and potentially life-threatening obstetric concern due to a rise in prevalence from 0.12% to 0.31% in recent years. New preventive measures, such as the bladder filling technique, seek to identify the bladder's borders, protect it, and displace it away from the lower uterine segment during placental removal.
To determine whether the saline bladder filling technique prevents the incidence rate of intraoperative bladder injuries among pregnant women undergoing PAS surgery.
Systematic searches were conducted in PubMed, Embase, and the Cumulative Index to Nursing, Allied Health Literature and, Google Scholar from 2013 to 2023. The Cochrane Risk of Bias (ROB 2.0) and ROB in Nonrandomized Studies of Interventions tools were used to assess the quality of the selected studies.
A total of 2,094 articles were initially retrieved, and after screening, four articles met the eligibility criteria and were included in the final. The primary outcome of this systematic literature review (SLR) indicates that the utilization of the bladder filling technique was associated with a reduced occurrence of bladder injury, with an incidence range of 4.5% to 21.9% when the bladder filling technique utilized, in contrast to an incidence range of 13.1% to 32.4% when the bladder-filling technique was not utilized. Furthermore, the utilization of the bladder filling technique was found to be correlated with a reduced surgical procedure time and decreased blood loss.
This SLR reveals that utilizing the bladder filling technique during PAS surgeries decreases the occurrence of intraoperative bladder injury, which, in turn, reduces the occurrence of other intraoperative complications, including intraoperative blood loss. Therefore, healthcare providers and policymakers should start developing surgical protocols for the use of this technique, as it has the potential to significantly impact the outcomes of pregnant women undergoing PAS surgeries.
近年来，胎盘植入谱系疾病（PAS）的患病率从0.12%上升至0.31%，已成为一种严重且可能危及生命的产科问题，愈发受到关注。新的预防措施，如膀胱充盈技术，旨在确定膀胱边界、加以保护，并在胎盘娩出过程中将其从子宫下段移开。
确定生理盐水膀胱充盈技术能否预防接受PAS手术的孕妇术中膀胱损伤的发生率。
于2013年至2023年在PubMed、Embase、护理及相关健康文献累积索引数据库（CINAHL）和谷歌学术进行系统检索。采用Cochrane偏倚风险（ROB 2.0）工具和非随机干预研究中的偏倚风险工具评估所选研究的质量。
初步检索到2094篇文章，经筛选，4篇文章符合纳入标准并最终纳入。该系统文献综述（SLR）的主要结果表明，采用膀胱充盈技术与膀胱损伤发生率降低相关，采用膀胱充盈技术时发生率为4.5%至21.9%，而未采用膀胱充盈技术时发生率为13.1%至32.4%。此外，发现采用膀胱充盈技术与手术时间缩短和失血量减少相关。
该SLR表明，在PAS手术中采用膀胱充盈技术可降低术中膀胱损伤的发生率，进而减少包括术中失血在内的其他术中并发症的发生。因此，医疗服务提供者和政策制定者应着手制定使用该技术的手术方案，因为它有可能显著影响接受PAS手术的孕妇的结局。
