A Participant-assigned Interventional Research of Precesarean Internal Iliac Artery Balloon Catheterization for Managing Intraoperative Hemorrhage of Placenta Previa and Placenta Accreta Spectrum Disorders After Cesarean Section  

作　　者：Yao FAN Xun GONG Nan WANG Ke-tao MU Ling FENG Fu-yuan QIAO Su-hua CHEN Wan-jiang ZENG Hai-yi LIU Yuan-yuan WU Qiong ZHOU Yuan TIAN Qiang LI Yin XIE Fan-fan LI Meng-zhou HE Rajluxmee Beejadhursing Dong-rui DENG Xiao-yan XU 

机构地区：[1]Department of Gynecology and Obstrics,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China [2]Department of Interventional Radiology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China

出　　处：《Current Medical Science》2021年第2期336-341,共6页当代医学科学（英文）

基　　金：supported by grants from the NationalScience & Technology Pillar Program of China duringthe Twelfth Five-year Plan Period (No. 2014BAI05B05);the National Natural Science Foundation of China (No.81873843);the Foundation at Research Funds forthe Central Universities (No. 2017kfyXJJ102 and No.2019kfyXKJC053).

摘　　要：Placenta accreta spectrum disorder (PASD) and placenta previa (PP) are two of the mosthideous obstetric complications which are usually associated with a history of cesarean section(CS). Moreover, women with PASD, PP and/or a cesarean scarred uterus are more likely to haveadverse pregnancy outcomes, including blood transfusion, hysterectomy, pelvic organs damage,postpartum hemorhage, disseminated intravascular coagulation, multi-organ dysfunction syndromeand even maternal or fetal death. This study aimed to investigate the efficacy of precesareaninternal iliac artery balloon catheterization (BC) for managing severe hemorhage caused by PASDand PP with a history of CS. This participant-assigned interventional study was conducted inTongji Hospital. We recruited 128 women with suspected PASD, PP and a history of CS. Womenin the BC group accepted precesarean BC of bilateral internal iliac arteries before the scheduledcesarean delivery. Women in the control group underwent a conventional cesarean delivery.Intraoperative hemorrhage, transfusion volume, radiation dose, exposure time, complicationsand neonatal outcomes were discussed. There were significant differences in calculated bloodloss (CBL) between BC group and control group (1015.0±144.9 vs. 1467.0±171.0 mL, P=0.04).Precesarean BC could reduce intraoperative red blood cell (RBC) transfusion as compared withcontrol group (799.5±136.1 vs. 1286.0±161.6 mL, P=0.02) and lessen the rate of using bloodproducts (57.1% vs. 76.4%, P=0.02). The incidence of hysterectomy was also lower in BC groupthan in control group. Postpartum outcomes showed no significant differences between the twogroups, except that postoperation hospitalization was longer in BC group than in control group(6.7±0.4 vs. 5.8±0.2 days, P=0.03). Precesarean BC of internal iliac artery is an effective methodfor managing severe hemorrhage caused by PASD and PP with a cesarean scarred uterus, as it couldreduce intraoperative blood loss, lessen intraoperative RBC transfusions and potentially decreasehyst

关 键 词：NITROSAMINE COTININE urinary sodium excretion nutrient intake blood pressure 

分 类 号：R71[医药卫生—妇产科学]