scholarly journals The application of prophylactic balloon occlusion of the internal iliac artery for the treatment of placenta accreta spectrum with placenta previa: a retrospective case-control study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Ying Peng ◽  
Lai Jiang ◽  
Cheng Peng ◽  
Dabao Wu ◽  
Ling Chen
Keyword(s):  
Case Control Study ◽  
Internal Iliac Artery ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Case Control ◽  
Balloon Occlusion ◽  
Retrospective Case ◽  
Internal Iliac ◽  
Placenta Accreta Spectrum ◽  
Control Study

The Clinical Evaluation of IIA Balloon Occlusion for Pernicious Placenta Previa Patients with Placenta Accreta: A Retrospective Study

2021 ◽  
Author(s):  
Ling Hong ◽  
Aner Chen ◽  
Jinliang Chen ◽  
Xiuxiu Li ◽  
Wenming Zhuang ◽  
...  
Keyword(s):  
Blood Loss ◽  
Iliac Artery ◽  
Caesarean Delivery ◽  
Internal Iliac Artery ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Balloon Occlusion ◽  
Control Group ◽  
Estimated Blood Loss ◽  
Internal Iliac

Abstract Objective: This study aimed to evaluate the clinical efficacy of internal iliac artery(IIA) balloon occlusion in patients with pernicious placenta previa coexisting with placenta accreta. Background: Pernicious placenta previa is frequently reported to be complicated with placenta accreta, which contributes to serious consequences such as severe obstetric postpartum hemorrhage or even maternal mortality. Methods: Fifty-eight pernicious placenta previa patients complicated with placenta accreta were retrospectively reviewed. The ballon group consisted of 23 patients, who underwent a caesarean delivery with internal iliac artery occlusion. 35 patients were in the control group, who had a standard caesarean delivery. The primary outcomes were estimated blood loss (EBL), cesarean hysterectomy, and blood transferring volume. The secondary outcomes were operating time, intraoperative hemostatic approaches, surgical complications, balloon catheter–related complications, length of maternal stay, cost of hospitalization, and neonatal outcomes.Results: No difference was observed in estimated blood loss (EBL), blood transferring percentages and volume, additional measures to secure hemostasis , surgical complications, hospital stay postoperatively and newborn outcomes. More than 40% of the balloon group underwent hysterectomy because of uncontrollable postpartum bleeding (10[43.48%] vs. 11[31.43%],P=0.350).Complications related to occlusion of IIA did not occur.The duration of the surgery of the balloon group was significantly longer than that of the control group(123.52 min±74.76 versus 89.17±48.68,P=0.038), and the total hospitalization cost was also significantly higher than that of the control group(45116.67±9358.67 yuan versus 30615.41±11587.44yuan,P=0.000).Conclusion: IIA balloon occlusion in patients with pernicious placenta previa coexisting with placenta accreta did not reduce the hysterectomy rate during cesarean section, nor did it reduce blood loss and blood transfusion, but it prolonged the duration of the surgery and increased the total cost.

scholarly journals Experience of Managing Suspected Placenta Accreta Spectrum with or without Internal Iliac Artery Balloon Occlusion in Two Lithuanian University Hospitals

Medicina ◽  
2021 ◽  
Vol 57 (4) ◽  
pp. 345
Author(s):  
Egle Savukyne ◽  
Laura Liubiniene ◽  
Zita Strelcoviene ◽  
Ruta Jolanta Nadisauskiene ◽  
Edita Vaboliene ◽  
...  
Keyword(s):  
Blood Loss ◽  
Cesarean Delivery ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Intervention Group ◽  
Balloon Occlusion ◽  
Endovascular Procedure ◽  
Intraoperative Blood Loss ◽  
Internal Iliac ◽  
Placenta Accreta Spectrum

Background and objectives: Placenta previa and placenta accreta spectrum are considered major causes of massive postpartum hemorrhage. Objective: To determine whether the placement of an occlusion balloon catheter in the internal iliac artery could reduce bleeding and other related complications during cesarean delivery in patients with placenta previa and placenta accreta spectrum. Materials and Methods: A retrospective analysis was conducted at two tertiary obstetric units of Lithuania. From January 2016 to November 2019 patients with placenta previa and antenatally suspected invasive placenta were included in the intervention group and underwent cesarean delivery with endovascular procedure. From January 2014 to December 2015 patients with placenta previa and suspected placenta accreta spectrum were included in the non-intervention group. The primary outcomes were reduction in intraoperative blood loss and transfusion volumes in the intervention group. Secondary outcomes were the incidence of hysterectomy and maternal complications. Results: Nineteen patients underwent cesarean delivery with preoperative endovascular procedure, and 47 women underwent elective cesarean delivery. The median intraoperative blood loss (1000 (400–4500) mL vs. 1000 (400–5000) mL; p = 0.616) and the need for red blood cell transfusion during operation (26% vs. 23%; p = 0.517) did not differ significantly between the patients groups. Seven patients in the intervention group and two patients in the non-intervention group underwent perioperative hysterectomy (p = 0.002). None of the patients had complications related to the endovascular procedure. Conclusion: The use of intermittent balloon occlusion catheter in patients with placenta pathology is a safe method but does not significantly reduce intraoperative blood loss during cesarean delivery.

The effect of the duration between the previous ceserian section and the current pregnancy on the incidence of placenta accreta spectrum: A Case Control Study

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Rehab M Abdelrahman ◽  
Tarek Aly Raafat ◽  
Ahmed Gamal Abdelnasser ◽  
Safaa Bakr Farag Allah Elghatwary
Keyword(s):  
Short Duration ◽  
Caesarean Delivery ◽  
Case Control Study ◽  
Placenta Accreta ◽  
Statistical Significance ◽  
Case Control ◽  
Control Group ◽  
Severe Bleeding ◽  
Placenta Accreta Spectrum ◽  
Control Study

Abstract Background Placenta accreta spectrum is a serious obstetric disorder that is characterized by deeply penetrating villi which are abnormally attached to the myometrium of the uterus. This prevents its complete dissociation during the third stage of labor that may cause severe bleeding, with its marked risk on the mother life. All recent studies confirm that the occurrence of placenta accreta increased dramatically in the recent years with the increasing number of caesarean sections. The number of previous caesarean deliveries accompanied by placenta previa markedly increase the risk for placenta accreta. There is a continued need to study risk factors of abnormally adherent placenta to improve the antenatal diagnosis . Objective The current study aims to evaluate the effect of the short duration between the perior caesarean delivery and the current pregnancy on the occurence of placenta accreta spectrum. Patients and Methods a case control study which was performed in the Maternity Hospital of Ain Shams University. It compare the duration between the perior caesarean section and the current pregnancy in the placenta accreta cases and the matched controls to determine if it increases the occurrences of placenta accreta or not. It include all pregnant ladies with placenta accreta spectrum diagnosed radiologically or surgically in the period of the beginning of June 2019 to the beginning of December 2019 with in the inclusion criteria, also the matched controls. Results there was no difference with a statistical significance between control group and patients group regarding inter pregnancy interval. Conclusion this study reveals that there was no effect of the short duration between the previous caesarean delivery and the current pregnancy on the occurence of placenta accreta spectrum.

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