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Background: Abnormal invasive placentation leads to massive intraoperative hemorrhage and maternal morbidity. This study aimed to assess the impact of the preoperative use of internal iliac artery balloon occlusion (IIABO) catheters in patients who had a cesarean delivery (CD) for invasive placentation, commonly known as the placenta accreta spectr...
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... 40%-50% of women had massive blood loss, with 30%-40% of them requiring more than five units of blood transfusion. More than 70% required additional hemostatic surgical measures, with one in four ending up having hysterectomy (Table 4). However, the use of IIABO in our study was associated with a nonsignificant reduction in measures to control the massive hemorrhage. ...Similar publications
Cesarean section for placenta previa accreta spectrum carries a significant risk of massive hemorrhage. Hence, it is necessary to understand the various hemostatic procedures, damage control surgery and resuscitation for massive hemorrhage, and systemic management against hypovolemic shock and coagulopathy. In cases of placenta previa with previous...
Citations
... Multiple logistic regression showed that the number of weeks at pregnancy termination and the presence of placenta accreta were positively associated with BBT failure. Previous studies have shown that the incidence of placenta accreta is substantially increasing in many Western countries [25][26][27]. Placenta previa with accreta is often the leading indication for peripartum hysterectomy [1,4,6]. Grönvall et al. [13] observed placenta accreta in 26/127 women with placenta previa, and 15 of these women underwent peripartum hysterectomy at the time of delivery. ...
Background: To evaluate the success rate of Bakri balloon tamponade (BBT) and the risk factors for BBT failure in the treatment of intraoperative and postpartum hemorrhage (PPH) in patients with placenta previa. Methods: Patients with placenta previa who underwent cesarean section and had BBT insertion for PPH were consecutively included from 2016 to 2018. Patients with placenta previa who successfully underwent routine insertion of a BBT during cesarean section and had their bleeding controlled were classified as the balloon success group. Patients who successfully underwent BBT during cesarean section but continued to have uncontrolled bleeding were classified as the balloon failure group. Multiple logistic regression was performed to examine the risk factors for BBT failure. Results: During the study, 270 women with placenta previa were identified. The success rate of BBT for managing PPH was 69.3%. The balloon failure group (n = 83) comprised those who had undergone BBT insertion, followed by B-lynch suture (n = 10), uterine artery ascending branch ligation (n = 32), pelvic arterial embolization (n = 21), or cesarean hysterectomy (n = 20). The intraoperative blood loss was 3098 mL (700–18,000 mL) in the balloon failure group and 1120 mL (500–4000 mL) in the balloon success group, respectively (p < 0.01). Multiple logistic regression analysis showed that the number of weeks at pregnancy termination (odds ratio [OR] = 1.188, 95% confidence interval [CI]: 1.023–1.379), the presence of placenta accreta (OR = 2.472, 95% CI: 1.361–4.493), and placenta previa classification (OR = 4.798, 95% CI: 1.328–17.337) were positively associated with BBT failure, while preoperative albumin levels (OR = 0.788, 95% CI: 0.714–0.869) were negatively related to BBT failure. Conclusion: This study suggests that BBT is effective as the second-line treatment for PPH associated with placenta previa in the Chinese population. Placenta accreta and major previa are risk factors for BBT failure. However, our findings need to be confirmed in larger samples with different ethnicities.
