Application of abdominal aortic balloon occlusion followed by uterine artery embolization for the treatment of pernicious placenta previa complicated with placenta accreta during cesarean section

Wang, Yanli; Huang, Guo‐Hao; Jiang, Tian; Han, Xinwei

doi:10.1016/j.jimed.2019.09.010

Cited by 6 publications

(7 citation statements)

References 19 publications

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“…Additionally, the abdominal aortic balloon occlusion technique entails a unilateral approach with a reduced insertion duration and minimizes radiation exposure to both fetus and mother, making it the most widely used method in clinical practice. 17,18 Nevertheless, the efficacy of balloon occlusion in reducing hemorrhage is inherently constrained. The temporal limitations inherent to the application of balloon occlusion techniques may not suffice for patients with severe PAS, who are at risk of substantial bleeding prior to the closure of the uterine cavity.…”

Section: Discussionmentioning

confidence: 99%

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Application of Uterine Artery Embolization in Patients With Placenta Accreta Spectrum After Abdominal Aortic Balloon Occlusion

Zhang,

Cheng,

Zhi

et al. 2024

Vasc Endovascular Surg

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Objective To evaluate the application of different uterine artery embolization procedures under balloon occlusion of the abdominal aorta in patients with Placenta Accreta Spectrum (PAS) undergoing cesarean section. Materials and Methods A retrospective analysis was performed on clinical data from 72 patients who underwent uterine artery embolization for hemostasis during cesarean section with PAS. The patients were divided into two groups according to the embolization method used during surgery: group A (n = 43) underwent uterine artery embolization by withdrawing the balloon and inserting a Cobra catheter into the uterine artery for embolization, while group B (n = 29) underwent uterine artery embolization with a Cobra catheter inserted via contralateral puncture of the femoral artery and balloon occlusion. General information, surgical data, and postoperative recovery were compared between the 2 groups. Results The bleeding and transfusion volumes were lower in group B than in group A and the differences between the 2 groups were statistically significant. There were no significant differences in surgical duration, number of embolized vessels, length of hospital stay, postoperative complications, or menstrual recovery between the 2 groups. Conclusion For patients with PAS undergoing cesarean section, uterine artery embolization for hemostasis is preferably performed by inserting a Cobra catheter via contralateral puncture of the femoral artery under abdominal aortic balloon occlusion.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Application of Uterine Artery Embolization in Patients With Placenta Accreta Spectrum After Abdominal Aortic Balloon Occlusion

Zhang,

Cheng,

Zhi

et al. 2024

Vasc Endovascular Surg

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“…[ 10 ] Furthermore, due to the placental position, weakness of uterine myometrium during pregnancy and other factors, it is difficult to observe the placenta in the posterior wall of the uterine body by ultrasound, and the diagnosis of PPP with placental accreta still has limitations. [ 11 ] PPP can lead to abnormal relationship between placenta and uterine muscle wall. [ 12 ] If it is not predicted or found in time, it may endanger the safety of mother and baby.…”

Section: Discussionmentioning

confidence: 99%

Expression of ADAM17 and its clinical value for patients with pernicious placenta previa: A retrospective study of 148 PPP patients underwent cesarean section

Huang,

Wang,

Xiao

et al. 2024

Medicine

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To explore the expression and the diagnostic value of ADAM17 in pernicious placenta previa (PPP) combined placental accreta. A total of 148 PPP patients were enrolled and divided into 2 groups: 62 patients with placenta accrete (PPP with PA group) and 86 patients without placenta accrete (PPP without PA group). In the same period, 74 pregnant women without PPP who had undergone cesarean section were selected as controls. The levels of ADAM17 were detected by qt-PCR. Diagnostic efficiency of ADAM17 were evaluated by receiver operating characteristics curve. ADAM17 was higher expression in PPP patients. Multivariate analysis showed that ADAM17 was related to gravida times (HR = 2.43 95% CI, 1.25–3.31), history of cesarean delivery (HR = 3.44, 95% CI = 2.24–4.28), history of abortions (HR = 2.22, 95% CI = 1.57–3.06) for PPP with PA patients and gravida times (HR = 2.01, 95% CI = 1.45–2.86), history of cesarean delivery (HR = 1.89, 95% CI = 1.33–2.48) for PPP patients without PA. Diagnostic efficiency of ADAM17 indicated that the sensitivity and specificity of ADAM17 detection for PPP with PA were 74.41% and 67.21% and for PPP without PA were 89.29% and 85.52%. Area under curve were 0.7876 (0.7090–0.8661) for PPP with PA and 0.9443 (0.9136–0.9750) for PPP without PA. Insummary, ADAM17 was higher expression in patients with PPP. ADAM17 was associated with gravida times, history of cesarean delivery, history of abortions. It also indicated a better diagnostic efficiency for patients with PPP. Further larger sample, multicenter studies should be conducted to confirm the conclusion from our study.

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“…[29,30] Other work suggested that prophylactic intraoperative abdominal aortic balloon occlusion could not control massive hemorrhage in patients with PAS disorder during cesarean delivery. [31] However, there is limited information on the roles of prophylactic uterine artery embolization in PAS disorder. It is interesting to conduct a research on the effects of prophylactic uterine artery embolization on PAS disorder in the future studies.…”

Section: Discussionmentioning

confidence: 99%

Prophylactic uterine artery embolization during cesarean delivery for management of hemorrhage in complete placenta previa: An observational study

Liu

Yang

et al. 2023

Medicine

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Complete placenta previa is a major cause of morbidity and mortality in pregnant women and fetuses. This study aimed to evaluate whether prophylactic uterine artery embolization (PUAE) could reduce bleeding in patients with complete placenta previa. We retrospectively analyzed patients with complete placenta previa admitted to Taixing People's Hospital for elective cesarean delivery between January 2019 and December 2020. The women were treated with PUAE (PUAE group, n = 20) or without (control group, control, n = 20). Risk factors for bleeding (age, gestational age, pregnancy times, delivery times, cesarean delivery times), intraoperative blood loss, hemoglobin difference before and after surgery, transfusions volume, hysterectomy cases, major maternal complication cases, neonatal birth weight, neonatal Apgar score in 1 minute, postoperative hospitalization time were compared between 2 groups. There were no significant differences on risk factors for bleeding, neonatal birth weight, neonatal Apgar score in 1 minute, postoperative hospitalization time between 2 groups. However, the intraoperative blood loss, hemoglobin before and after operation, transfusion volume in the PUAE group was significantly lower than the control. There was no case of hysterectomy or major maternal complications in both groups. PUAE during cesarean may be an effective and safe strategy to reduce intraoperative blood loss and transfusion volume for patients with complete placenta previa.

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Application of abdominal aortic balloon occlusion followed by uterine artery embolization for the treatment of pernicious placenta previa complicated with placenta accreta during cesarean section

Cited by 6 publications

References 19 publications

Application of Uterine Artery Embolization in Patients With Placenta Accreta Spectrum After Abdominal Aortic Balloon Occlusion

Application of Uterine Artery Embolization in Patients With Placenta Accreta Spectrum After Abdominal Aortic Balloon Occlusion

Expression of ADAM17 and its clinical value for patients with pernicious placenta previa: A retrospective study of 148 PPP patients underwent cesarean section

Prophylactic uterine artery embolization during cesarean delivery for management of hemorrhage in complete placenta previa: An observational study

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