Clinical evaluation of preoperative abdominal aortic balloon occlusion in patients with placenta increta or percreta

Abstract Background Placenta increta or percreta will result in severe postpartum hemorrhage and become a research hotspot in obstetrics. Preoperative abdominal aortic balloon occlusion (AABO), as a new intravascular interventional therapy, has taken more and more attention in obstetrics. Thus, the aim of this study is to evaluate the safety and efficacy of abdominal aortic balloon occlusion. Methods Retrospective analysis of pregnant women with placenta increta or percreta delivered between January 2013 and April 2019 in the Sichuan Provincial People’s Hospital. The experimental group (AABO group) included 168 patients who underwent abdominal aortic balloon occlusion before cesarean section. The control group (NO-AABO group) was composed of 106 patients who underwent surgery without any preoperative intravascular interventional therapy. The parameters containing estimated blood loss, red cell suspension (RCS) transfusion volume, hysterectomy, surgery time, postoperative hospital days, neonatal status and complications were compared between the two groups. Results The patients with preoperative abdominal aortic balloon occlusion had significant reduction in blood loss volume, red cell suspension transfusion volume and plasma transfusion volume compared to patients without balloon. Similarly, the surgery time and hysterectomy were obviously reduced in AABO group. However, there were no differences in the Apgar scores and neonatal complications between the two groups, indicating that the abdominal aortic balloon has little adverse effect on the newborns. Conclusion AABO is a safe and effective technology for pregnant women with placenta increta or percreta to reduce blood loss volume and blood transfusion volume.

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Safety and efficacy of preoperative abdominal Aortic balloon occlusion in placenta increta and/or percreta

Journal of Surgical Research ◽

10.1016/j.jss.2017.10.002 ◽

2018 ◽

Vol 222 ◽

pp. 75-84 ◽

Cited By ~ 13

Author(s):

Wenjuan Sun ◽

Shuhong Duan ◽

Gang Xin ◽

Juan Xiao ◽

Fanzhen Hong ◽

...

Keyword(s):

Balloon Occlusion ◽

Placenta Increta ◽

Safety And Efficacy ◽

Aortic Balloon Occlusion ◽

Abdominal Aortic

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The clinical evaluation of preoperative abdominal aortic balloon occlusion for patients with placenta increta or percreta

The Journal of Maternal-Fetal & Neonatal Medicine ◽

10.1080/14767058.2021.1906219 ◽

2021 ◽

pp. 1-6

Author(s):

Yangming Liu ◽

Nan Shan ◽

Yu Yuan ◽

Bin Tan ◽

Hongbo Qi ◽

...

Keyword(s):

Clinical Evaluation ◽

Balloon Occlusion ◽

Placenta Increta ◽

Aortic Balloon Occlusion ◽

Abdominal Aortic

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Can Aortic Balloon Occlusion Reduce Blood Loss During Resection of Sacral Tumors That Extend Into the Lower Lumber Spine?

Clinical Orthopaedics and Related Research ◽

10.1007/s11999.0000000000000053 ◽

2018 ◽

Vol 476 (3) ◽

pp. 490-498 ◽

Cited By ~ 7

Author(s):

Yidan Zhang ◽

Wei Guo ◽

Xiaodong Tang ◽

Rongli Yang ◽

Taiqiang Yan ◽

...

Keyword(s):

Blood Loss ◽

Balloon Occlusion ◽

Reduce Blood Loss ◽

Aortic Balloon Occlusion ◽

Sacral Tumors

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Clinical outcomes and anesthetic management of pregnancies with placenta previa and suspicion for placenta accreta undergoing intraoperative abdominal aortic balloon occlusion during cesarean section

BMC Anesthesiology ◽

10.1186/s12871-020-01040-8 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Peng Li ◽

Xia Liu ◽

Xiangkui Li ◽

Xinchuan Wei ◽

Juan Liao

Keyword(s):

Cesarean Section ◽

Clinical Outcomes ◽

Placenta Accreta ◽

Placenta Previa ◽

Anesthetic Management ◽

Balloon Occlusion ◽

Aortic Balloon Occlusion ◽

Abdominal Aortic

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A small case series of aortic balloon occlusion in trauma: lessons learned from its use in ruptured abdominal aortic aneurysms and a brief review

European Journal of Trauma and Emergency Surgery ◽

10.1007/s00068-015-0574-0 ◽

2015 ◽

Vol 42 (5) ◽

pp. 585-592 ◽

Cited By ~ 22

Author(s):

T. M. Hörer ◽

P. Skoog ◽

A. Pirouzram ◽

K. F. Nilsson ◽

T. Larzon

Keyword(s):

Case Series ◽

Abdominal Aortic Aneurysms ◽

Balloon Occlusion ◽

Lessons Learned ◽

Aortic Aneurysms ◽

Small Case Series ◽

Aortic Balloon Occlusion ◽

Abdominal Aortic ◽

Ruptured Abdominal Aortic Aneurysms

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A new scoring system for placement of abdominal aortic balloon in Placenta accreta spectrum patients with placenta previa: A retrospective cohort study

10.21203/rs.3.rs-898065/v1 ◽

2021 ◽

Author(s):

Fusen Huang ◽

Jingjie Wang ◽

Qiuju Xiong ◽

Wenjian Wang ◽

Yi Xu ◽

...

Keyword(s):

Blood Transfusion ◽

Blood Loss ◽

Scoring System ◽

Placenta Accreta ◽

Placenta Previa ◽

Operation Time ◽

Balloon Occlusion ◽

Abdominal Aortic ◽

Placenta Accreta Spectrum ◽

New Scoring

Abstract Background In recent years, abdominal aortic balloon occlusion is considered an effective method for placenta accreta spectrum patients with placenta previa. However, not all patients in this category require abdominal aortic balloon placement. This study aims to investigate whether the new scoring system is effective for the placement of the abdominal aortic balloon in Placenta accreta spectrum (PAS)patients with placenta previa. Methods PAS patients with placenta previa diagnosed by color Doppler ultrasound were included, and divided into three groups according to their scores graded by a new scoring system (grade Ⅰ group ≤ 5 points, 6 points ≤ grade Ⅱ group ≤ 9 points, grade Ⅲ group ≥ 10 points). Patients with grade Ⅲ were placed with an abdominal aortic balloon unless their families and patients strongly refused. Those with grade I were not placed with an abdominal aortic balloon. Those with grade II generally were not placed with an abdominal aortic balloon unless their families and patients strongly request. Indicators were analyzed, including postpartum hemorrhage, transfusion requirements, operation time, and the ability to preserve the uterus and fertility. Results Estimated blood loss, the number of intraoperative transfused patients, postoperative days were different among the three groups. In group 2 (grade II), there was no significant difference in other observation indexes༈intraoperative blood loss 629 ± 214 vs 758 ± 749, P = 0.488, packed red blood cells47 ± 194 vs 154 ± 445, P = 0.488, admission to ICU 0/7 vs 3/71, P = 1.000, total hysterectomies 0/7 vs 2/71, P = 1.000༉(except for the operation time81.4 ± 19.5 vs 61.7 ± 30.6, P = 0.013) between the abdominal aortic balloon and non-abdominal aortic balloon groups. In group 3 (grade III), significant differences were found in intraoperative blood loss (950 ± 390 vs 2238 ± 1052, P༜0.001), packed red blood cells(213 ± 311 vs 662 ± 528, P༜0.001), postoperative blood transfusion volume(105 ± 181 vs 300 ± 321, P = 0.008), operation time(90.0 ± 25.9 vs 115.9 ± 45.3, P = 0.013), the proportion of people who need blood transfusion(14 in the IABO vs 11 in the NIABO, P = 0.002) and the total Hysterectomies (0 in the IABO vs 2 in the NIABO, P = 0.011) between the abdominal aortic balloon and non-abdominal aortic balloon groups. Conclusion With the new scoring system, not all patients with PAS and placenta previa need a preventive temporary balloon occlusion of the subrenal abdominal aorta. We recommend placing an abdominal aortic balloon in patients with grade III, for it can control intraoperative bleeding and reduce intraoperative blood transfusion, and reduce the risk of hysterectomy. For patients with grade I and II, abdominal aortic balloon placement is not recommended.

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