Timing of intra-abdominal aortic balloon occlusion for prevention of hemorrhage in patients with placenta previa and placenta accreta spectrum

作者全名："Huang, Fusen; Wang, Jingjie; Liu, Xiaonan; Xiong, Qiuju; Wang, Wenjian; Xu, Yi; Pan, Yaping; Yang, Xiaojuan"

作者地址："[Huang, Fusen; Liu, Xiaonan; Xiong, Qiuju; Wang, Wenjian; Xu, Yi; Yang, Xiaojuan] Chongqing Med Univ, Affiliated Hosp 1, Dept Anesthesiol, Chongqing, Peoples R China; [Wang, Jingjie] Chongqing Med Univ, Affiliated Hosp 1, Dept Radiol, Chongqing, Peoples R China; [Pan, Yaping] Chongqing Med Univ, Affiliated Hosp 1, Dept Obstet, Chongqing, Peoples R China; [Huang, Fusen] Chongqing Med Univ, Affiliated Hosp 1, 1 Youyi Rd, Chongqing 400016, Peoples R China"

通信作者："Huang, FS (通讯作者)，Chongqing Med Univ, Affiliated Hosp 1, 1 Youyi Rd, Chongqing 400016, Peoples R China."

来源：INTERNATIONAL JOURNAL OF GYNECOLOGY & OBSTETRICS

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001000055600001

JCR分区：Q2

影响因子：2.6

年份：2023

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期号：　

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文献类型：Article; Early Access

关键词：cesarean delivery; intra-abdominal aortic balloon occlusion; massive bleeding; placenta accreta spectrum; placenta previa

摘要："ObjectivePlacenta accreta spectrum (PAS) has been linked to severe negative maternal-fetal pregnancy outcomes, including a high risk of maternal death. The goal of this study was to determine whether an abdominal aortic balloon block performed before fetal birth lowered intraoperative bleeding and the risk of severe bleeding, as opposed to a block performed after fetal birth. MethodsIn this retrospective cohort study, patients who underwent pre-delivery or post-delivery inflation were compared for intraoperative hemorrhage, transfusion rate, hysterectomy rate, intensive care unit (ICU) hospitalization, and newborn indices. To ensure the robustness of our findings, we applied multivariate logistic regression, propensity score analysis, and an inverse probability-weighting model. ResultsThis study included 168 patients who underwent balloon occlusion (62 pre-delivery, 106 post-delivery). The overall probability of major bleeding was 56.5% (95/168), and the pre-delivery and post-delivery probabilities for major bleeding were 64.5% (40/62) and 51.9% (55/106) (P = 0.112), respectively. In the multivariable-adjusted model, post-delivery inflation was associated with a 33% numerically higher probability of massive bleeding (odds ratio 1.33, 95% confidence interval 0.54-3.25, P = 0.535). However, the difference was not statistically significant. ConclusionAccording to our findings, pre-delivery inflation did not significantly reduce the risk or amount of severe bleeding."

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