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The efficacy of pre-delivery prophylactic trans-catheter arterial balloon occlusion of bilateral internal iliac artery in patients with suspected placental adhesion. Obstet Gynecol Sci 2017; 60:18-25. [PMID: 28217667 PMCID: PMC5313359 DOI: 10.5468/ogs.2017.60.1.18] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 08/17/2016] [Accepted: 08/20/2016] [Indexed: 11/26/2022] Open
Abstract
Objective Prophylactic trans-catheter arterial balloon occlusion (PTABO) before cesarean section of placenta previa totalis has been introduced to prevent massive hemorrhage. The purpose of this study is to evaluate the clinical usefulness of PTABO in cases of suspected placental adhesion and to examine antepartal risk factors and perinatal outcomes in women with placental adhesion. Methods Between January 2012 and December 2015, 77 patients who had undergone ultrasonography for evaluation of placenta previa were enrolled in this study. Seventeen of these patients with suspected placental adhesion by ultrasonography and Pelvic MRI underwent PTABO before cesarean section and another 59 patients underwent cesarean section without PTABO. Antepartal risk factors and peripartum maternal and neonatal outcomes were compared between patients with PTABO and those without PTABO. Results More advanced maternal age, longer in gestational weeks at delivery, and more common previous cesarean section history were observed in the PTABO group. Placenta adhesion, abnormal Doppler findings, and frequency of transfusion were more common in the PTABO group. However there was no significant difference in estimated blood loss, hospital days, and neonatal outcome. It had occurred 3 cases of hysterectomy and 1 case of uterine artery embolization after cesarean section in the PTABO group. Conclusion Close surveillance of antepartum risk factors for placental adhesion using ultrasonography and pelvic magnetic resonance imaging is important to prevention of massive hemorrhage during cesarean section. PTABO before cesarean section might result in reduced blood loss and requirement for transfusion during the operation.
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Yamamoto T, Suzuki Y, Suzuki H, Fujii S, Matsushita H, Watanabe K, Wakatsuki A. Novel histological findings in the uterus after interventional radiology: a case report of placenta accreta. HYPERTENSION RESEARCH IN PREGNANCY 2017. [DOI: 10.14390/jsshp.hrp2017-002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Tamao Yamamoto
- Department of Obstetrics and Gynecology, Aichi Medical University School of Medicine
| | - Yoshikatsu Suzuki
- Department of Obstetrics and Gynecology, Aichi Medical University School of Medicine
| | - Hiroki Suzuki
- Department of Obstetrics and Gynecology, Aichi Medical University School of Medicine
| | - Saki Fujii
- Department of Obstetrics and Gynecology, Aichi Medical University School of Medicine
| | - Hiroshi Matsushita
- Department of Obstetrics and Gynecology, Aichi Medical University School of Medicine
| | - Kazushi Watanabe
- Department of Obstetrics and Gynecology, Aichi Medical University School of Medicine
| | - Akihiko Wakatsuki
- Department of Obstetrics and Gynecology, Aichi Medical University School of Medicine
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Malagón Reyes RM, Castorena de Ávila R, Ángeles Vázquez MDJ, Núñez Monteagudo CA, Mendieta Zerón H. Sclerotherapy with 6% polidocanol solution in patients with placenta accreta. Taiwan J Obstet Gynecol 2016; 55:654-658. [DOI: 10.1016/j.tjog.2015.11.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2015] [Indexed: 10/20/2022] Open
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Wu Q, Liu Z, Zhao X, Liu C, Wang Y, Chu Q, Wang X, Chen Z. Outcome of Pregnancies After Balloon Occlusion of the Infrarenal Abdominal Aorta During Caesarean in 230 Patients With Placenta Praevia Accreta. Cardiovasc Intervent Radiol 2016; 39:1573-1579. [PMID: 27439624 PMCID: PMC5052309 DOI: 10.1007/s00270-016-1418-y] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Accepted: 07/07/2016] [Indexed: 12/02/2022]
Abstract
Purpose To explore the efficacy and safety of prophylactic temporary balloon occlusion of the infrarenal abdominal aorta during caesarean for the management of patients with placenta praevia accreta. Methods Two hundred and sixty-eight cases of placenta praevia accreta from January 2012 to June 2015 were retrospectively reviewed. Group A included two hundred and thirty patients who underwent prophylactic temporary balloon occlusion of infrarenal abdominal aorta followed by caesarean section. Group B included thirty-eight patients who underwent caesarean without endovascular intervention. The parameters including operating room time, estimated blood loss, blood transfusion volume, PT (prothrombin time) during operation, days in the intensive care unit, and total hospital days were compared between the two groups. Results The operating room time, estimated blood loss, PT, the incidence of hysterectomy, blood transfusion volume, postpartum haemorrhage, and days in intensive care unit were lower in group A than in group B, with statistical significance (P < 0.05). There was no significant difference in the Apgar scores of the neonates and the incidences of thrombosis in lower limbs between the two groups (P > 0.05). No patient in the group with prophylactic temporary balloon occlusion of the infrarenal abdominal aorta was performed hysterectomy, while three patients in group B were performed hysterectomy because of uncontrollable haemorrhage. Conclusions The results indicate that prophylactic temporary balloon occlusion of infrarenal abdominal aorta followed by caesarean section is safe and effective to control intraoperative blood loss and greatly decreases the risk of hysterectomy in patients with placenta praevia accreta.
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Affiliation(s)
- Qinghua Wu
- Departments of Prenatal Diagnosis, and Obstetrics, Obstetric Critical Treatment Center of Henan Province, The First Affiliated Hospital of Zhengzhou University, Jian She Dong Lu, No 1, Zhengzhou City, Henan Province, China
| | - Zhuan Liu
- Obstetric Critical Treatment Center of Henan Province, Department of Obstetrics, The First Affiliated Hospital of Zhengzhou University, Jian She Dong Lu, No 1, Zhengzhou City, Henan Province, China
| | - Xianlan Zhao
- Obstetric Critical Treatment Center of Henan Province, Department of Obstetrics, The First Affiliated Hospital of Zhengzhou University, Jian She Dong Lu, No 1, Zhengzhou City, Henan Province, China.
| | - Cai Liu
- Obstetric Critical Treatment Center of Henan Province, Department of Obstetrics, The First Affiliated Hospital of Zhengzhou University, Jian She Dong Lu, No 1, Zhengzhou City, Henan Province, China
| | - Yanli Wang
- Department of Anesthesiology, The First Affiliated Hospital of Zhengzhou University, Jian She Dong Lu, No 1, Zhengzhou City, Henan Province, China
| | - Qinjun Chu
- Department of Anesthesiology, The First Affiliated Hospital of Zhengzhou University, Jian She Dong Lu, No 1, Zhengzhou City, Henan Province, China
| | - Xiaojuan Wang
- Obstetric Critical Treatment Center of Henan Province, Department of Obstetrics, The First Affiliated Hospital of Zhengzhou University, Jian She Dong Lu, No 1, Zhengzhou City, Henan Province, China
| | - Zhimin Chen
- Obstetric Critical Treatment Center of Henan Province, Department of Obstetrics, The First Affiliated Hospital of Zhengzhou University, Jian She Dong Lu, No 1, Zhengzhou City, Henan Province, China
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