title: Efficacy of temporary ligation of infrarenal abdominal aorta during cesarean section in pernicious placenta previa.
abstract: To evaluate the efficacy and safety of temporary loop ligation of the infrarenal abdominal aorta for control of intraoperative blood loss in patients with pernicious placenta previa.  Methods: We retrospectively analyzed the clinical data of 14 patients with pernicious placenta previa, who underwent temporary loop ligation of the infrarenal abdominal aorta for control of blood loss during cesarean section between July 2013 and December 2014.  Results: Eight patients received conservative management to preserve the uterus and 6 patients underwent cesarean hysterectomy. The occlusion time of the abdominal aorta was (31.42±12.67) min. The average estimated intraoperative blood loss was (1 117.85±745.13) mL. The volume of packed red blood cell transfusion was (3.91±3.24) units, and the volume of fresh frozen plasma transfusion was (192.85±156.71) mL. Post-operative histologic diagnosis revealed 6 cases of placenta percreta, 4 of increta, 3 of accreta and 1 non-creta. All patients experienced an uneventful postoperative recovery.  Conclusion: In patients with pernicious placenta previa, temporary ligation of the infrarenal abdominal aorta provide a safe and effective means for controlling intraoperative hemorrhage during cesarean section. Additionally, the procedure may provide an opportunity to preserve fertility by avoiding a cesarean hysterectomy.
authors.affiliation: Department of Obstetrics and Gynecology, Third Xiangya Hospital, Central South University, Changsha 410013, China.
authors.forename: Shuangying
authors.initials: S
authors.lastname: Huang
authors.affiliation: Department of Obstetrics and Gynecology, Third Xiangya Hospital, Central South University, Changsha 410013, China.
authors.forename: Aibin
authors.initials: A
authors.lastname: Xia
authors.affiliation: Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston TX 77030, USA.
authors.forename: Grace
authors.initials: G
authors.lastname: Jamail
authors.affiliation: Department of Obstetrics and Gynecology, Third Xiangya Hospital, Central South University, Changsha 410013, China.
authors.forename: Mailian
authors.initials: M
authors.lastname: Long
authors.affiliation: Department of Obstetrics and Gynecology, Third Xiangya Hospital, Central South University, Changsha 410013, China.
authors.forename: Chunxia
authors.initials: C
authors.lastname: Cheng
mesh_terms: D001012:Aorta, Abdominal; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D002585:Cesarean Section; D000072700:Conservative Treatment; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000706:statistics & numerical data*; D008026:Ligation / Q000009:adverse effects / Q000379:methods*; D061646:Operative Time; D010921:Placenta Accreta / Q000175:diagnosis; D010923:Placenta Previa; D011247:Pregnancy; D012189:Retrospective Studies; D012449:Safety