The Study On The Effect Of Clinical Outcomes Of Abdominal Aortic Balloon Occlusion Combined With Bilateral Uterine Artery Ligation In Patients With Placenta Increta

Objective: To investigate the effect of clinical outcomes of abdominal aortic balloon occlusion combined with bilateral uterine artery ligation in patients with placenta increta.Methods:81 cases of patients with placenta increta who underwent prophylactic abdominal aortic balloon occlusion before caesarean section in the department of obstetrics and gynecology of Sichuan Provincial People’s Hospital from January 2017 to December 2018 were analyzed retrospectively.Patients underwent intraoperative bilateral uterine artery ligation in 43 cases were divided into the study group.Meanwhile,patients carried out prophylactic abdominal aortic balloon occlusion before caesarean section only were divided into control group.We counted the age,gestational week,gestational time,delivery time,cesarean section time of the two groups and compared the estimated intraoperative blood loss,operation time,transfused blood volume,volume of intraoperative intravenous fluid,hysterectomy rate,DIC(Disseminated Intravascular Coagulation)rate,ICU(Intensive Care Unit)stay,the difference between preoperative hemoglobin and postoperative hemoglobin,blood loss within postoperative 24 hours,postoperative hospital stay,Apgar scores of the neonates,the birth weight of the neonates and the premature rate.We analyzed the effectiveness of abdominal aortic balloon occlusion combined with bilateral uterine artery ligation.Results: There was no significant difference in the age,gestational weeks,gestational times,delivery times,cesarean section times between two groups(P>0.05).Equally,the operation time,transfused blood volume,volume of intraoperative intravenous fluid,hysterectomy rate,DIC(Disseminated Intravascular Coagulation)rate,ICU(Intensive Care Unit)stay,postoperative hospital stay has no significance between two groups(P>0.05).The estimated intraoperative blood loss(930.23±333.47 ml vs 1213.15±750.91ml),difference between preoperative hemoglobin and postoperative hemoglobin of the study group(10.95±9.92g/L vs 15.86±11.33g/L),blood loss within postoperative 24h(997.67±337.26 ml vs 1313.68±617.57ml)was lower than that in the control group with a significant difference(P<0.05).No patients underwent hysterectomy in the study group while 2 patients underwent hysterectomy in the control group.Each group has 2 patients been treated with thrombectomy by doppler ultrasound-diagnosed lower extremity thrombosis.There were 1 patient developed postoperative infection was discharged after anti-infective treatment in the control group.There were no surgical-related complications and organ damages in the two groups.Conclusion: Preoperative abdominal aortic balloon occlusion combined with bilateral uterine artery ligation can effectively reduce intraoperative and postoperative blood loss in patients with placenta increta and improve patients’ clinical outcomes.Meanwhile,intraoperative bilateral uterine artery ligation does not increase the risk of surgical-related complications.