A Meta-analysis Of The Efficacy Of Prophylactic Abdominal Aorta Balloon Occlusion In Patients With Pernicious Placenta Previa And Placenta Accrete

Objective:To systematically evaluate the value of prophylactic abdominal aortic balloon occlusion in patient with pernicious placenta previa and placenta accrete,and provide evidence-based reference for the clinical treatment.Methods:Retrieved from PubMed,CNKI,VIP database and WanFang Data,retrospective cohort studies about prophylactic abdominal aortic balloon occlusion in patient with pernicious placenta previa and placenta accreta were collected.The search time is up to March 17,2018.The relevant literature was screened and the quality was assessed.Meta-analysis was performed by using RevMan 5.3.Results:2 randomized controlled trial and 13 cohort studies met the inclusion criteria,all of which had a score of 8 in assessment using NOS.There were 502 cases in the control group,820 cases in the observation group.Results of meta-analysis showed that the patients in the interventional group had a significant decrease in the intraoperative blood loss(SMD=-4.23,95%CI-5.96 ~-2.50,P<0.00001),the blood transfusion volume(SMD=-7.94,95%CI-12.53~-3.36,P=0.0007),the uterus resection(OR=0.30,95%CI 0.21 ~ 0.42,P < 0.00001)and the postoperative hospitalization days(SMD=-1.06,95%CI-2.05~0.08,P=0.03)as compared with the control group(P< 0.05).There was no significant difference in the Apgar scores of the neonates(SMD=0.38,95%CI-0.24 ~ 1.00,P=0.23)、operational time(SMD=-1.02,95%CI-2.30 ~ 0.26),P=0.12)and newborns weight(SMD=0.12,95%CI-0.11~0.34,P=0.32)between the two groups.Conclusion:Prophylactic abdominal aorta balloon occlusion can reduce the intraoperative blood loss,blood transfusion volume,the uterus resection rate,and the postoperative hospitalization days.It provides a new treatment for pregnant women with pernicious placenta previa and placenta accrete.