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Clinical and Experimental Obstetrics & Gynecology  2021, Vol. 48 Issue (3): 487-493    DOI: 10.31083/j.ceog.2021.03.2295
Original Research Previous articles | Next articles
Intraoperative infrarenal aortic balloon occlusion in pregnancies with placenta accreta spectrum disorder
Mengdie Luo1, , Junxing Li2, , Xiaofeng Yang3, Qiang Huang3, Mengwei Huang3, Jie Mei1, *()
1Department of Obstetrics and Gynecology, Affiliated Hospital of Southwest Medical University, 646000 Luzhou, Sichuan Province, China
2Department of Obstetrics and Gynecology, People's Hospital of Deyang City, 618000 Deyang, Sichuan Province, China
3Department of Obstetrics and Gynecology, Department of Interventional Radiology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, School of Medicine, Affiliated Hospital of University of Electronic Science and Technology of China, 610031 Chengdu, Sichuan Province, China
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Abstract  
Background: The objective of this study was to evaluate the efficacy of intraoperative aortic balloon occlusion (IABO) during caesarean section for placenta accreta, increta or percreta and explore the relationship between different profile balloon catheters and catheter-related complications. Methods: This retrospective case control study included 295 patients with pathologically confirmed placenta accreta spectrum (PAS) disorder at the Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital between 2013 and 2019. The characteristics of 162 patients who had aortic balloon occlusion (balloon group) were compared with those of 133 patients who had no catheterization (control group). Results: There were significant differences between the two groups in estimated blood loss, calculated blood loss, number of transfusions, transfused packed red blood cells (PRBCs), haemoglobin reduction, operation time and caesarean hysterectomy (P < 0.05). Regarding different PAS disorders, the estimated blood loss among women with placenta accreta and placenta increta was lower in the balloon group (n = 32 and 102, respectively) than in the non-balloon group (n = 33 and 85; P = 0.04 and P < 0.01, respectively). Only the placenta increta group showed a significant difference (P < 0.01) in transfused PRBCs. In patients who used the low-profile balloon catheters, we found a significant reduction in catheter-related complications compared with the high-profile group (n = 52 vs. 110, P = 0.04). Conclusions: Our study demonstrated that intraoperative infrarenal aortic balloon occlusion was effective in both reducing intraoperative haemorrhage and blood transfusion, and in preventing hysterectomy during caesarean section for pathologically diagnosed placenta accreta and increta. Low-profile balloon catheters can reduce catheter-related complications.
Key words:  Aortic balloon occlusion      Caesarean section      Interventional therapy      Placenta accreta      Thrombus     
Submitted:  16 September 2020      Revised:  08 December 2020      Accepted:  28 December 2020      Published:  15 June 2021     
Fund: 
30305031540(H)/Sichuan Medical Association
*Corresponding Author(s):  Jie Mei     E-mail:  meijie2023@swmu.edu.cn
About author:  These authors contributed equally.

Cite this article: 

Mengdie Luo, Junxing Li, Xiaofeng Yang, Qiang Huang, Mengwei Huang, Jie Mei. Intraoperative infrarenal aortic balloon occlusion in pregnancies with placenta accreta spectrum disorder. Clinical and Experimental Obstetrics & Gynecology, 2021, 48(3): 487-493.

URL: 

https://ceog.imrpress.com/EN/10.31083/j.ceog.2021.03.2295     OR     https://ceog.imrpress.com/EN/Y2021/V48/I3/487

[1] Eren Akbaba. Can high transverse skin incision (Modified Maylard) be a new alternative in placenta accreta spectrum management with cesarean hysterectomy?[J]. Clinical and Experimental Obstetrics & Gynecology, 2021, 48(3): 686-690.
[2] Yu Huang, Fang-Yuan Luo. Clinical efficacy of aortic balloon occlusion during caesarean section in patients with placenta accreta spectrum disorders: a systematic review and meta-analysis[J]. Clinical and Experimental Obstetrics & Gynecology, 2021, 48(2): 234-244.
[3] Shi-Fu Hu, Ying-Ying Wang, Yan-Qing Wu, Qiong Yu. Timing of prophylactic antibiotic use during elective caesarean section: a meta-analysis of randomised controlled trials[J]. Clinical and Experimental Obstetrics & Gynecology, 2021, 48(1): 31-36.
[4] Dubravko Habek, Matija Prka, Anto Čartolovni, Anis Cerovac, Domagoj Dokozić. Caesarean section between doctrine to heresis. Medicoethical and deontological view of caesarology: an opinion[J]. Clinical and Experimental Obstetrics & Gynecology, 2021, 48(1): 1-4.
[5] G. Garuti, E. Castellacci, S. Calabrese, S. Calzolari. Hysteroscopic removal of retained products of conception with enhanced vascularity: a study of reliability[J]. Clinical and Experimental Obstetrics & Gynecology, 2020, 47(4): 472-477.
[6] K. Tamura, H. Takahashi, S. Uchida, M. Ogoyama, R. Usui, S. Matsubara. Intrauterine balloon failure: unrecognized placenta accreta spectrum disorders[J]. Clinical and Experimental Obstetrics & Gynecology, 2020, 47(3): 405-408.
[7] Z.R. Zheng, X. Xie, Y. Hou, P. Xie, X. Yu, L. Xie. Intraoperative infrarenal aortic balloon occlusion in pregnancies with placenta accreta, increta, and percreta[J]. Clinical and Experimental Obstetrics & Gynecology, 2019, 46(5): 704-708.
[8] B. Díaz-Rabasa, R. Crespo Esteras, A. Agustín-Oliva, R.A. Laborda Gotor, P. Tobías González, C. De Bonrostro Torralba, S. Castán Mateo. Has advanced maternal age a real impact on intrapartum caesarean rate?[J]. Clinical and Experimental Obstetrics & Gynecology, 2019, 46(1): 55-59.
[9] X.W. Sun, X.M. Bai, Q. Chen, J.F. Shen, L. Yang, J.Y. Zhang, X.S. Gu, Q. Yuan, J. Jing, Y. Jin. Preset catheter sheaths for uterine arterial embolization in the cesarean section of pernicious preplacental placenta: its application[J]. Clinical and Experimental Obstetrics & Gynecology, 2019, 46(1): 108-112.
[10] A. Tsiola, D. Marioli, I. Papadimitriou, V. Tsapanos, N. A. Georgopoulos. Increased kisspeptin mRNA expression derived from abnormally adhered placenta: compensatory inhibition of abnormal placental invasion?[J]. Clinical and Experimental Obstetrics & Gynecology, 2018, 45(2): 204-208.
[11] A.S. Adlan, M.F. Zainal Abidin, C.C.W. Yim. Difference in outcomes of category 1 caesarean section patients in relation to type of anaesthesia administered: a tertiary university hospital experience[J]. Clinical and Experimental Obstetrics & Gynecology, 2018, 45(2): 245-248.
[12] H. Kyozuka, K. Takiguchi, A. Owada, Y. Endo, M. Kojima, S. Suzuki, K. Fujimori. Two cases of placenta accreta with conservative management[J]. Clinical and Experimental Obstetrics & Gynecology, 2018, 45(2): 283-286.
[13] S. Aslam, D. Al-Jaroudi. Women's involvement with the decision of caesarean section and their degree of satisfaction[J]. Clinical and Experimental Obstetrics & Gynecology, 2018, 45(1): 88-92.
[14] A. Okada, K. Tanaka, K. Kajitani, S. Nishimoto, H. Nakamura, O. Nakamoto. Near-infrared spectroscopy during cesarean section with common iliac artery balloon occlusion for total placenta previa: a case report[J]. Clinical and Experimental Obstetrics & Gynecology, 2018, 45(1): 112-114.
[15] B. Tuncali. A rare cause of intractable tachycardia during caesarean section: acute cannabis use[J]. Clinical and Experimental Obstetrics & Gynecology, 2017, 44(5): 804-805.
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