Outcomes of prophylactic abdominal aortic balloon occlusion in patients with placenta previa accreta: a propensity score matching analysis
Abstract Background Placenta previa accreta is a life-threatening pregnancy complication, and reducing blood loss during operative treatment remains a major challenge. The aim of our study was to investigate the effect of prophylactic abdominal aortic balloon occlusion (AABO) during caesarean sectio...
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| Format: | Article |
| Language: | English |
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BMC
2022-06-01
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| Series: | BMC Pregnancy and Childbirth |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12884-022-04837-2 |
| _version_ | 1811229981625286656 |
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| author | Huifen Yin Rong Hu |
| author_facet | Huifen Yin Rong Hu |
| author_sort | Huifen Yin |
| collection | DOAJ |
| description | Abstract Background Placenta previa accreta is a life-threatening pregnancy complication, and reducing blood loss during operative treatment remains a major challenge. The aim of our study was to investigate the effect of prophylactic abdominal aortic balloon occlusion (AABO) during caesarean section in women with placenta previa accreta. Methods A retrospective study of women with placenta previa accreta was conducted in a tertiary hospital from January 1, 2015, to December 31, 2020. Women were divided into balloon and control groups by whether AABO was performed. Baseline characteristics and pregnancy outcomes were compared in the two groups. A propensity score analysis was applied to minimise the indication bias. The primary outcome was composite, including estimated blood loss (EBL) ≥ 2.0 L, massive transfusion and hysterectomy. Results A total of 156 patients participated in this study, with 68 in the balloon group and 88 in the control group. Propensity score analysis showed that women in the balloon group had less EBL (1590.36 ± 1567.57 vs. 2830.36 ± 2285.58 mL, P = 0.02) as well as a lower proportion of EBL ≥ 1.0 L (50.00% vs. 78.57%, P = 0.03), EBL ≥ 2.0 L (21.43% vs. 50.00%, P = 0.03) and EBL ≥ 3.0 L (14.29% vs. 42.86%, P = 0.04). In addition, women in the control group received more red blood cell transfusions (8.43 U ± 9.96 vs. 3.43 U ± 6.27, P = 0.03), and the proportion of massive transfusions was higher (35.71% vs. 7.14%, P = 0.02). The proportions of disseminated intravascular coagulation (0% vs. 28.57%, P < 0.01), haemorrhagic shock (3.57% vs. 32.14%, P = 0.02) and hysterectomy (10.71% vs. 39.29%, P = 0.03) were significantly lower in the balloon group. Sutures were performed more often in the balloon group (64.29% vs. 17.86%, P < 0.01). Multivariate logistic regression analysis showed that AABO was associated with the primary outcome (adjusted odds ratio 0.46, 95% confidence interval 0.23 ~ 0.96, P = 0.04). No serious balloon catheter-related complications occurred in the balloon group. Conclusion AABO was an effective and safe approach to improve maternal outcomes for patients with placenta previa accreta. |
| first_indexed | 2024-04-12T10:22:32Z |
| format | Article |
| id | doaj.art-39638567e35a4fd5bbcf0f5853ee69da |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-04-12T10:22:32Z |
| publishDate | 2022-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-39638567e35a4fd5bbcf0f5853ee69da2022-12-22T03:37:04ZengBMCBMC Pregnancy and Childbirth1471-23932022-06-012211910.1186/s12884-022-04837-2Outcomes of prophylactic abdominal aortic balloon occlusion in patients with placenta previa accreta: a propensity score matching analysisHuifen Yin0Rong Hu1Obstetrics Department, Obstetrics and Gynecology Hospital of Fudan UniversityObstetrics Department, Obstetrics and Gynecology Hospital of Fudan UniversityAbstract Background Placenta previa accreta is a life-threatening pregnancy complication, and reducing blood loss during operative treatment remains a major challenge. The aim of our study was to investigate the effect of prophylactic abdominal aortic balloon occlusion (AABO) during caesarean section in women with placenta previa accreta. Methods A retrospective study of women with placenta previa accreta was conducted in a tertiary hospital from January 1, 2015, to December 31, 2020. Women were divided into balloon and control groups by whether AABO was performed. Baseline characteristics and pregnancy outcomes were compared in the two groups. A propensity score analysis was applied to minimise the indication bias. The primary outcome was composite, including estimated blood loss (EBL) ≥ 2.0 L, massive transfusion and hysterectomy. Results A total of 156 patients participated in this study, with 68 in the balloon group and 88 in the control group. Propensity score analysis showed that women in the balloon group had less EBL (1590.36 ± 1567.57 vs. 2830.36 ± 2285.58 mL, P = 0.02) as well as a lower proportion of EBL ≥ 1.0 L (50.00% vs. 78.57%, P = 0.03), EBL ≥ 2.0 L (21.43% vs. 50.00%, P = 0.03) and EBL ≥ 3.0 L (14.29% vs. 42.86%, P = 0.04). In addition, women in the control group received more red blood cell transfusions (8.43 U ± 9.96 vs. 3.43 U ± 6.27, P = 0.03), and the proportion of massive transfusions was higher (35.71% vs. 7.14%, P = 0.02). The proportions of disseminated intravascular coagulation (0% vs. 28.57%, P < 0.01), haemorrhagic shock (3.57% vs. 32.14%, P = 0.02) and hysterectomy (10.71% vs. 39.29%, P = 0.03) were significantly lower in the balloon group. Sutures were performed more often in the balloon group (64.29% vs. 17.86%, P < 0.01). Multivariate logistic regression analysis showed that AABO was associated with the primary outcome (adjusted odds ratio 0.46, 95% confidence interval 0.23 ~ 0.96, P = 0.04). No serious balloon catheter-related complications occurred in the balloon group. Conclusion AABO was an effective and safe approach to improve maternal outcomes for patients with placenta previa accreta.https://doi.org/10.1186/s12884-022-04837-2Placenta previaPlacenta accretaProphylactic abdominal aortic balloon occlusionPropensity score analysis |
| spellingShingle | Huifen Yin Rong Hu Outcomes of prophylactic abdominal aortic balloon occlusion in patients with placenta previa accreta: a propensity score matching analysis BMC Pregnancy and Childbirth Placenta previa Placenta accreta Prophylactic abdominal aortic balloon occlusion Propensity score analysis |
| title | Outcomes of prophylactic abdominal aortic balloon occlusion in patients with placenta previa accreta: a propensity score matching analysis |
| title_full | Outcomes of prophylactic abdominal aortic balloon occlusion in patients with placenta previa accreta: a propensity score matching analysis |
| title_fullStr | Outcomes of prophylactic abdominal aortic balloon occlusion in patients with placenta previa accreta: a propensity score matching analysis |
| title_full_unstemmed | Outcomes of prophylactic abdominal aortic balloon occlusion in patients with placenta previa accreta: a propensity score matching analysis |
| title_short | Outcomes of prophylactic abdominal aortic balloon occlusion in patients with placenta previa accreta: a propensity score matching analysis |
| title_sort | outcomes of prophylactic abdominal aortic balloon occlusion in patients with placenta previa accreta a propensity score matching analysis |
| topic | Placenta previa Placenta accreta Prophylactic abdominal aortic balloon occlusion Propensity score analysis |
| url | https://doi.org/10.1186/s12884-022-04837-2 |
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