Feasibility of Infrarenal Abdominal Aorta Balloon Occlusion in Pernicious Placenta Previa Coexisting with Placenta Accrete

Abstract

Objective. To evaluate the efficacy and safety of prophylactic balloon occlusion of the infrarenal abdominal aorta in pernicious placenta previa coexisting with placenta accrete. Methods. This retrospective study was performed in patients with placenta accreta complicated with pernicious placenta previa between January 2014 and December 2016 in Shengjing Hospital; 56 patients with a pathological diagnosis were included. The degree of placental invasion was evaluated by preoperative color Doppler ultrasonography and/or magnetic resonance imaging, and all patients in this study should undergo balloon occlusion preoperatively, which was a determination made by specific doctors. The control group consisted of 32 patients who underwent cesarean section alone, and the study group included 24 patients who underwent cesarean section with preoperative balloon occlusion. Prevention of hysterectomy was the primary outcome evaluated. The secondary outcomes include operative duration, estimated blood loss, blood transfusion, prothrombin time postoperatively, decrease in the hemoglobin level postoperatively, intensive care unit admission, pathological diagnosis, and total hospital stay (days), and these data were compared between the two groups. Additionally, the neonatal outcomes, premature delivery, Apgar scores at 1 minute and 5 minutes, neonatal birth weight, hospitalization, and mortality were compared. Results. There was a significant difference in the rate of hysterectomy between the two groups (p<0.05). However, no differences were observed between the groups in any other outcomes. Conclusion. The prophylactic use of infrarenal abdominal aortic balloon occlusion is an effective and safe option for treating pernicious placenta previa coexisting with placenta accreta.