title: Aortic balloon occlusion for controlling intraoperative hemorrhage in patients with placenta previa increta/percreta.
abstract: OBJECTIVE
  To investigate whether abdominal aortic balloon occlusion (ABO) effectively reduces intraoperative hemorrhage in patents with placenta previa increta/increta.
  
  
  METHODS
  Forty-three women were diagnosed as placenta previa increta/percreta by ultrasound and MRI. These patients' assessments were taken by their chief physician, and they were under necessity of previous cesarean section as confirmed by the committee of experts during consultation. There was no significant difference in disease risk rating between them in whole process. Although our department provided a more appropriate method, 10 of 43 patients chose intraoperative aortic balloon occlusion (IABO). Other 33 patients who refused that suggestion were considered as control group. Fully informed consents were obtained from all patients in this study group. The intraoperative blood loss, blood transfusion, rate of hysterectomy and complications of mothers and fetus of IABO group and control group were analyzed.
  
  
  RESULTS
  The median intraoperative blood loss was 1000 ml in the IABO group compared with 2000 ml in the control group (p < 0.05). The median volume of transfused red blood cells was 1100 ml in the IABO group compared with 2000 ml in the control group (p < 0.05). 33.3% (11/33) patients in the control group had hemorrhagic shock, and one of them suffered from cardiac arrest intraoperatively because of severe bleeding. However, none of these serious events occurred in the IABO group (p < 0.05). The hysterectomy rate was 70% (7/10) in the IABO group and 63.3% (21/33) in the control group (p > 0.05). No IABO-related complications were observed in the mother and fetus.
  
  
  CONCLUSIONS
  IABO is an effective and safe method to control intraoperative blood loss and blood transfusion in patients with placenta previa increta/percreta.
authors.affiliation: a Department of Obstetrics and Gynecology, The Second Hospital of Jinan University, People's Hospital of Shenzhen , Shenzhen , China.
authors.forename: Ying-Lan
authors.initials: YL
authors.lastname: Wang
authors.affiliation: a Department of Obstetrics and Gynecology, The Second Hospital of Jinan University, People's Hospital of Shenzhen , Shenzhen , China.
authors.forename: Fang-Ming
authors.initials: FM
authors.lastname: Su
authors.affiliation: a Department of Obstetrics and Gynecology, The Second Hospital of Jinan University, People's Hospital of Shenzhen , Shenzhen , China.
authors.forename: Hai-Ying
authors.initials: HY
authors.lastname: Zhang
authors.affiliation: a Department of Obstetrics and Gynecology, The Second Hospital of Jinan University, People's Hospital of Shenzhen , Shenzhen , China.
authors.forename: Fang
authors.initials: F
authors.lastname: Wang
authors.affiliation: a Department of Obstetrics and Gynecology, The Second Hospital of Jinan University, People's Hospital of Shenzhen , Shenzhen , China.
authors.forename: Rui-Lian
authors.initials: RL
authors.lastname: Zhe
authors.affiliation: b Department of Radiology, The Second Hospital of Jinan University, People's Hospital of Shenzhen , Shenzhen , China.
authors.forename: Xin-Ying
authors.initials: XY
authors.lastname: Shen
mesh_terms: D021721:Balloon Occlusion; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D016022:Case-Control Studies; D002585:Cesarean Section / Q000009:adverse effects*; D005260:Female; D006801:Humans; D010921:Placenta Accreta / Q000601:surgery*; D010923:Placenta Previa / Q000601:surgery*; D011247:Pregnancy
keywords: Placenta previa; aortic balloon occlusion; placenta inccreta; placenta percreta; safety