Background::Massive bleeding is the main concern for the management of placenta percreta (PP). Intra-abdominal aortic balloon occlusion (IABO) is one method for pelvic devascularization, but the efficacy of IABO is uncertain. This study aims to investigate the outcomes of IABO in PP patients.Methods::We retrospectively reviewed the clinical data of PP cases from six tertiary centers in China between January 2011 and December 2015. PP cases with/without the use of IABO were analyzed. Propensity score matching analysis was performed to reduce the effect of selection bias. Postpartum hemorrhage (PPH) and the rate of hysterectomy, as well as neonatal outcomes, were analyzed.Results::One hundred and thirty-two matched pairs of patients were included in the final analysis. Compared with the control group, maternal outcomes, including PPH (68.9% vs. 87.9%, χ2= 13.984, P < 0.001), hysterectomy (8.3% vs. 65.2%, χ2= 91.672, P < 0.001), and repeated surgery (1.5% vs. 12.1%, χ2 = 11.686, P= 0.001) were significantly reduced in the IABO group. For neonatal outcomes, Apgar scores at 1 minute (8.67 ± 1.79 vs. 8.53 ± 1.68, t=-0.638, P= 0.947) and 5 minutes (9.43 ± 1.55 vs. 9.53 ± 1.26, t = 0.566, P = 0.293) were not significantly different between the two groups. Conclusions::IABO can significantly reduce blood loss, hysterectomies, and repeated surgeries. This procedure has not shown harmful effects on neonatal outcomes.

Placenta accreta spectrum disorders;Placenta percreta;Conservative management;Intra-abdominal aortic balloon occlusion;Propensity score matching

Zheng Weiran;Dou Ruochong;Yan Jie;Yang Xinrui;Zhao Xianlan;Chen Dunjin;Ma Yuyan;Zhang Weishe;Ding Yiling;Fan Ling;Yang Huixia

Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing Key Laboratory of Maternal-Fetal Medicine of Gestational Diabetes Mellitus, Xicheng District, Beijing 100034, China;Department of Obstetrics and Gynecology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, China;Department of Obstetrics and Gynecology, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510260, China;Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Jinan, Shandong 250012, China;Department of Obstetrics and Gynecology, Xiangya Hospital Central South University, Changsha, Hunan 410008, China;Department of Obstetrics and Gynecology, Second Xiangya Hospital of Central South University, Changsha, Hunan 410008, China;Department of Obstetrics and Gynecology, Beijing Obstetrics and Gynecology Hospital, Beijing 100026, China

中华医学杂志（英文版）

[1]Zheng Weiran;Dou Ruochong;Yan Jie;Yang Xinrui;Zhao Xianlan;Chen Dunjin;Ma Yuyan;Zhang Weishe;Ding Yiling;Fan Ling;Yang Huixia-.Intra-abdominal aortic balloon occlusion in the management of placenta percreta)[J].中华医学杂志（英文版）,2022(04):441-446

percreta,hysterectomies

Intra,abdominal,aortic,balloon,occlusion,management,placenta,Background,Massive,bleeding,main,concern,IABO,one,method,pelvic,devascularization,but,efficacy,uncertain,This,study,aims,investigate,outcomes,patients,Methods,We,retrospectively,reviewed,clinical,data,cases,from,six,tertiary,centers,China,between,January,December,without,use,were,analyzed,Propensity,matching,analysis,was,performed,selection,bias,Postpartum,hemorrhage,PPH,rate,hysterectomy,well,neonatal,Results,One,hundred,thirty,two,matched,pairs,included,final,Compared,control,maternal,including,repeated,surgery,significantly,reduced,For,Apgar,scores,minutes,not,different,groups,Conclusions,blood,loss,surgeries,procedure,has,shown,harmful,effects,Placenta,accreta,spectrum,disorders,Conservative

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