Key result
Prophylactic abdominal aorta balloon occlusion reduced the incidence of estimated blood loss >1000 mL compared to no balloon occlusion (63% vs 90%; P=0.009).
Why the study?
Does prophylactic abdominal aorta balloon occlusion reduce bleeding in women with placenta previa and placenta accreta undergoing elective cesarean delivery?
Cohort (n=69)
No
Does prophylactic abdominal aorta balloon occlusion reduce bleeding in women with placenta previa and placenta accreta undergoing elective cesarean delivery?
Absolute Event Rate: 63% vs 90%
p-value: p=0.009
Prophylactic abdominal aorta balloon occlusion reduces the incidence of severe bleeding (>1000 mL) during cesarean delivery in women with placenta previa and abnormal placentation.
May support aortic balloon use in accreta deliveries; leaves open need for RCTs before practice change.
OBJECTIVE: To evaluate the effectiveness of prophylactic abdominal aorta balloon occlusion in cases of placenta previa with abnormal placentation. METHODS: In a retrospective study, data were analyzed for patients who had placenta previa with placenta accreta and underwent elective cesarean delivery (>34 weeks) with or without temporary aortic balloon occlusion at a center in Zhengzhou, China, between October 2015 and September 2016. The primary clinical outcomes were operative time, estimated blood loss, intraoperative blood transfusion volume, hemoglobin, hysterectomy, and hospitalization. RESULTS: Among 69 eligible women, 38 had temporary balloon occlusion, and 31 had no balloon occlusion. Operative time, blood transfusion volume, change in hemoglobin, hysterectomy, and length of hospitalization did not differ. Although mean blood loss did not differ, fewer patients in the balloon group than the non-balloon group had an estimated blood loss of more than 1000 mL (24 [63%] vs 28 [90%]; P=0.009). In terms of different placental types, the estimated blood loss among women with placenta accreta and placenta increta was lower in the balloon group than in the non-balloon group (P<0.001 and P=0.01, respectively). CONCLUSION: Prophylactic balloon occlusion of the abdominal aorta reduced bleeding after cesarean delivery for women with abnormal placentation.
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Cui et al. (2017) conducted a cohort in Placenta previa with abnormal placentation (n=69). Prophylactic abdominal aorta balloon occlusion vs. No balloon occlusion was evaluated on Estimated blood loss of more than 1000 mL (p=0.009). Prophylactic abdominal aorta balloon occlusion reduced the incidence of estimated blood loss >1000 mL compared to no balloon occlusion (63% vs 90%; P=0.009).
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