title: Outcome of Pregnancies After Balloon Occlusion of the Infrarenal Abdominal Aorta During Caesarean in 230 Patients With Placenta Praevia Accreta.
abstract: OBJECTIVE
  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.
authors.affiliation: 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.
authors.forename: Qinghua
authors.initials: Q
authors.lastname: Wu
authors.affiliation: 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.
authors.forename: Zhuan
authors.initials: Z
authors.lastname: Liu
authors.affiliation: 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. zxl121292014@163.com.
authors.forename: Xianlan
authors.initials: X
authors.lastname: Zhao
authors.affiliation: 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.
authors.forename: Cai
authors.initials: C
authors.lastname: Liu
authors.affiliation: Department of Anesthesiology, The First Affiliated Hospital of Zhengzhou University, Jian She Dong Lu, No 1, Zhengzhou City, Henan Province, China.
authors.forename: Yanli
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Anesthesiology, The First Affiliated Hospital of Zhengzhou University, Jian She Dong Lu, No 1, Zhengzhou City, Henan Province, China.
authors.forename: Qinjun
authors.initials: Q
authors.lastname: Chu
authors.affiliation: 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.
authors.forename: Xiaojuan
authors.initials: X
authors.lastname: Wang
authors.affiliation: 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.
authors.forename: Zhimin
authors.initials: Z
authors.lastname: Chen
mesh_terms: D000328:Adult; D001012:Aorta, Abdominal; D021721:Balloon Occlusion / Q000379:methods; D016063:Blood Loss, Surgical / Q000517:prevention & control; D001803:Blood Transfusion; D002585:Cesarean Section; D005260:Female; D006801:Humans; D007044:Hysterectomy; D007231:Infant, Newborn; D010921:Placenta Accreta / Q000601:surgery*; D010923:Placenta Previa / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology* / Q000517:prevention & control; D006473:Postpartum Hemorrhage / Q000517:prevention & control; D011247:Pregnancy; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Balloon occlusion of the infrarenal abdominal aorta; Caesarean; Placenta praevia accreta