Please wait a minute...
Clinical and Experimental Obstetrics & Gynecology  2019, Vol. 46 Issue (5): 704-708    DOI: 10.12891/ceog4723.2019
Original Research Previous articles | Next articles
Intraoperative infrarenal aortic balloon occlusion in pregnancies with placenta accreta, increta, and percreta
Z.R. Zheng1, X. Xie1, Y. Hou1, P. Xie2, X. Yu2, L. Xie1, *()
1Department of Obstetrics and Gynecology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
2Department of Interventional Radiology, Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
Download:  PDF(479KB)  ( 332 ) Full text   ( 9 )
Export:  BibTeX | EndNote (RIS)      
Abstract  

Objective: The objective of this study was to evaluate the efficacy of intraoperative aortic balloon occlusion (IABO) during cesarean section for placenta accreta, increta or percreta. Materials and Methods: This was a retrospective case-control study of patients with surgically or pathologically confirmed placenta accreta, increta or percreta who were examined from 2013 to 2017. One hundred and two patients (60%) had aortic balloon catheters placed before cesarean section (balloon group), and the other patients did not undergo balloon placement (control group). Clinical records from 170 subjects were reviewed. Results: Forty-nine patients were diagnosed as having placenta accreta (28.8%), 98 patients had placenta increta (57.6%), and 23 patients had placenta percreta (13.6%). Considering all subjects, the patients in the balloon group had a significantly reduced median estimated blood loss (p < 0.01), rate of transfusion (p = 0.02), amount of packed red blood cells (PRBCs) (p = 0.02), and decrease in hemoglobin levels (p = 0.03). Nine (8.8%) patients had catheterization-related complications, including eight cases of arterial or venous thrombosis. When the data were analyzed separately according to the different forms of abnormal invasive placenta, no difference in these surgical outcomes was observed between the two groups for women with placenta accreta or placenta percreta; however, for women with placenta increta who underwent IABO, the authors observed significant reductions in the estimated blood loss (p < 0.01), the amount of transfused PRBCs (p = 0.01), the extent to which hemoglobin levels decreased after surgery (p = 0.01), and the incidence of cesarean hysterectomy (p = 0.04). Conclusions: Although IABO was efficacious in both reducing intraoperative hemorrhage and blood transfusion, and in preventing hysterectomy during cesarean section for placenta increta, it should only be used on the basis of an accurate antenatal diagnosis, as it has a high risk of thrombosis and a high cost; immediate cesarean hysterectomy still seems to be the optimal management for placenta percreta.

Key words:  Aorta occlusion      Abnormal invasive placenta      Balloon catheter      Caesarean section      Placenta accreta     
Published:  10 October 2019     
*Corresponding Author(s):  L. XIE     E-mail:  841423692@qq.com

Cite this article: 

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. Clinical and Experimental Obstetrics & Gynecology, 2019, 46(5): 704-708.

URL: 

https://ceog.imrpress.com/EN/10.12891/ceog4723.2019     OR     https://ceog.imrpress.com/EN/Y2019/V46/I5/704

[1] Aliki Tympa, Charalampos Grigoriadis. The Hassiakos maneuver: how to test neuraxial anesthesia before Cesarean section[J]. Clinical and Experimental Obstetrics & Gynecology, 2021, 48(5): 1061-1064.
[2] Mahmoud Alalfy, Soha Talaat Hamed, Alaa Sobhi Abd El Ghani, Ahmed Elgazzar, Amr Abbassy, Ahmed S. S. A. Rashwan, Omar Nagy, Mohamed A Shalaby, Hatem Hassan, Asmaa Ibrahem, Hesham Kamal, Reham Mahrous, Eman Kamal. The accuracy of 3D-TUI and 3D power Doppler using Alalfy simple criteria in the diagnosis of placenta accreta spectrum[J]. Clinical and Experimental Obstetrics & Gynecology, 2021, 48(5): 1132-1140.
[3] Valeria Filippi, Luigi Raio, Sophia Amylidi-Mohr, Rudolf Tschudi, Daniele Bolla. Epidural analgesia at trial of labour after caesarean section. A retrospective cohort study over 12 years[J]. Clinical and Experimental Obstetrics & Gynecology, 2021, 48(4): 913-917.
[4] Mengdie Luo, Junxing Li, Xiaofeng Yang, Qiang Huang, Mengwei Huang, Jie Mei. Intraoperative infrarenal aortic balloon occlusion in pregnancies with placenta accreta spectrum disorder[J]. Clinical and Experimental Obstetrics & Gynecology, 2021, 48(3): 487-493.
[5] 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.
[6] 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.
[7] 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.
[8] 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.
[9] 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.
[10] 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.
[11] 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.
[12] 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.
[13] 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.
[14] 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.
[15] 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.
No Suggested Reading articles found!