The effectiveness of prophylactic internal iliac artery balloon occlusion in the treatment of patients with pernicious placenta previa coexisting with placenta accreta

Aim: This study aimed to explore the therapeutic effectiveness of prophylactic internal iliac artery balloon occlusion (IIABO) during cesarean delivery in the management of patients with pernicious placenta previa (PPP) coexisting with placenta accreta (PA).Methods: This retrospectively study enrolled 83 patients diagnosed with PPP coexisting with PA in our hospital between January 2014 and December 2017. The patients were divided into the study group (n=58, receiving routine cesarean section followed prophylactic IIABO) and control group (n=25, receiving routine cesarean section alone). The general situation, intraoperative conditions, maternal and neonatal outcomes, and postoperative complications between the two groups were compared.Results: The two groups were comparable due to no significant difference in the general situation of patients. The intraoperative conditions, such as intraoperative and postoperative blood loss, transfusion volume and the incidence rate of transfusion in the study group were significantly lower than those in the control group, but the incidence rate of disseminated intravascular coagulation and hysterectomy did not exhibit significant differences. Moreover, maternal and neonatal outcomes were not significantly different. Besides, in the study group, a patient with left foot numbness appeared left popliteal artery thrombosis and four patients experienced fever of <38.5C and lower abdominal pain. In the control group, a patient underwent hysterectomy.Conclusions: Prophylactic IIABO is an alternative method to control postpartum hemorrhage in the treatment of PPP coexisting with PA. However, it may not decrease the incidence of hysterectomy.

Automated summary

Prophylactic IIABO is effective in reducing postpartum hemorrhage in patients with PPP coexisting with PA, but may not decrease the incidence of hysterectomy. The study group had lower intraoperative blood loss and transfusion volume compared to the control group. Both maternal and neonatal outcomes were similar between the two groups.