腹主动脉球囊封堵联合剖宫产术治疗凶险性前置胎盘的安全性随访研究

目的 探讨腹主动脉球囊封堵联合剖宫产术治疗凶险性前置胎盘的安全性和有效性,评估其对患者生育功能和新生儿健康状况的影响.方法 回顾性分析2013年1月至2019年1月我院收治的1018例凶险性前置胎盘患者的临床资料.所有患者均接受腹主动脉球囊封堵联合剖宫产术治疗.本研究旨在通过分析1018例患者的手术时间、术中出血量、输...

Safety follow-up study of abdominal aortic balloon occlusion combined with cesarean section in the treatment of pernicious placenta previa

Objective To investigate the safety and efficacy of abdominal aortic balloon occlusion combined with cesarean section in the treatment of pernicious placenta previa,and to evaluate its impact on the reproductive function and neonatal health.Methods The clinical data of 1018 patients with pernicious placenta previa admitted to our hospital from January 2013 to January 2019 were retrospectively analyzed.All patients received abdominal aortic balloon occlusion combined with cesarean section.The purpose of this study was to evaluate the safety and efficacy of abdominal aortic balloon occlusion combined with cesarean section in the treatment of dangerous placenta previa by analyzing the operation time,intraoperative blood loss,blood transfusion,intraoperative and postoperative complications,postoperative recovery,fetal radiation exposure time and dose,and neonatal Apgar score in 1018 cases.Results Among all the 1018 patients,940 patients received only abdominal aortic balloon occlusion,78 patients underwent uterine artery embolization due to postoperative bleeding.All patients successfully preserved the uterus.Except for 8 cases of right femoral artery thrombosis and 3 cases of right lower limb intermuscular venous thrombosis,the remaining patients did not have postoperative lower limb arteriovenous thrombosis,renal insufficiency,late postpartum hemorrhage,ectopic embolism,spinal cord or peripheral nerve damage or pelvic infection or other serious complications.The mean operation time was(57.6±17.3)min.The average intraoperative blood loss was(590±570)mL.One hundred and twenty-six patients(12.38%,126/1018)were given blood transfusion,with an average of(630±450)mL.The average hospital stay was(6.4±4.2)d,the average fetal radiation exposure time was(5.1±1.4)s,and the average dose was(4.0±2.6)mGy in 1018 cases.Neonatal Apgar scores were(9.2±0.4)at 1 min and(9.6±0.3)at 5 min.During follow-up until May 31,2019,38 cases were lost to follow-up,137 were in lactation,and 843 had recurrent menstruation.Except for 38 cases lost to follow-up,the remaining 982 surviving newborns(including 2 twins)showed no abnormalities in the 42-days postnatal outpatient follow-up examination.Conclusions Balloon occlusion of abdominal aorta combined with cesarean section is a safe and effective method for the treatment of pernicious placenta previa,which can reduce the risk of hysterectomy,decrease intraoperative blood loss,and have no adverse effects on pregnant women or newborns.