Comparison Of The Clinical Effect Between Different Occlusion Time Of The Lower Abdominal Aorta Balloon In Cesarean Section For Pernicious Placenta Previa

Background and ObjectiveThe Pernicious Placenta Previa(PPP)refers to the previous history of cesarean section or myomectomy,placenta previa is considered in this pregnancy,and the placenta stick on the original scar of the cesarean section,often accompanied with placental accrete spectrum(PAS),leading to life-threatening hemorrhage,high hysterectomy rate and other complications.With the development of interventional technology,abdominal aortic balloon occlusion is more and more used in the cesarean section of dangerous placenta previa,but there is no uniform standard for the timing of intraoperative occlusion.Retrospective analysis the influence of different blocking time of abdominal aortic balloon on the maternal and neonatal outcomes of the patients with pernicious placenta previa.MethodsFrom September 2015 to July 2019,105 cases of PPP with placenta accrete spectrum were hospitalized in the Second Affiliated Hospital of Zhengzhou University and terminated their pregnancy by ultrasound-guided lower abdominal aortic balloon occlusion during cesarean section.50 cases(the group of blocking before delivery)underwent abdominal aortic balloon occlusion while cutting myometrium during cesarean section.The other 55 cases(the group of blocking after delivery)underwent block the abdominal aorta after delivery.Then according to the ultrasound scoring system about placenta accrete spectrum offered by the team of Chong Yiwen from the Third Hospital of Peking University to evaluate the types of placenta accrete spectrum,the 105 patients was divided into another two groups:placenta inrcreta group(ultrasound score 5-10 points)and percreta percreta group(ultrasound score ≥10 points).The intraoperative bleed loss,hysterectomy rate,Interventional complications and neonatal condition between the two groups were compared.ResultsFor the group of placenta increta,there was no significant difference between the two groups in terms of intraoperative hemorrhage,operation time,hysterectomy rate,bladder injury rate,and neonatal condition;For the group of placenta percreta,There was no significant difference in operation time,hysterectomy rate,bladder injury rate and neonatal condition between the two groups.However,in the aspect of intraoperative bleeding,the group of blocking before delivery was significantly lower than that in the group of blocking after delivery.Conclusionsthe different occlusion timing of abdominal aortic balloon during cesarean section has no significant effect on the maternal and neonatal outcomes of the patients with placenta increta;for the patients with placenta percreta,the loss of bleeding during the operation in the group of blocking before delivery was less than that in the group of blocking after delivery.