Comparison of Efficacy between Internal Iliac Artery and Abdominal Aorta Balloon Occlusions in Pernicious Placenta Previa Patients with Placenta Accrete.

BACKGROUND

We aimed to compare the hemostatic effect and perioperative outcomes between internal iliac artery (IIA) and abdominal aorta (AA) balloon occlusions in pernicious placenta previa patients complicated with placenta accrete and underwent cesarean delivery.

METHODS

One hundred and twenty-three pernicious placenta previa patients complicated with placenta accrete were retrospectively reviewed. Patients who received IIA or AA occlusions were subsequently divided into the IIA group (n = 71) and AA group (n = 52). Estimated blood loss (EBL) and blood transferring volume were evaluated.

RESULTS

No difference was observed in EBL during cesarean delivery, EBL within 24 h or blood transferring volume between IIA and AA groups. Subgroup analysis disclosed that AA occlusion presented lower EBL during cesarean delivery and EBL within 24 h compared to IIA occlusion in placenta percreta subgroup. For secondary outcomes, IIA occlusion caused better Apgar score at 1 min but higher rates of IIA ligation and iodoform gauze packing of the uterine cavity compared to AA occlusion. Multivariate linear analysis revealed that invasion depth independently predicted worse EBL.

CONCLUSION

IIA and AA occlusions have similar hemostatic effects in pernicious placenta previa patients with placenta accrete underwent cesarean delivery, while AA occlusion is more effective in reducing EBL in placenta percreta subgroup.