Clinical Study Of Interventional Assisted Cesarean Section Of Cesarean Section

?? Clinical evaluation of low abdominal aorta balloon occlusion assists cesarean section for pernicious placenta previaObjective To evaluate the efficacy and safety of temporary balloon occlusion(ABO)of the low abdominal aorta in cesarean section(CS)for pernicious placenta previa(PPP).Materials and methods The clinical date of 68 patients with PPP(non-penetrating placenta implant patients)admitted to our hospital during the period from January 2014 to December 2016,were retrospectively analyzed.ABO assisted CS in 44 cases as study group,simple cesarean section in 24 cases as control group.The operation time,intraoperative blood loss,intraoperative blood transfusion,blood loss within postoperative 24 h,hysterectomy rate,hospital stay after cesarean section,Apgar score and birth weights of the two groups were compared.Results There was no significant difference in the age,gestational week,pregnancy,parity,and PA between the two groups(P>0.05).Comparing the three indicators of blood loss,intraoperative blood transfusion volume,and hysterectomy rate in the cesarean section,the observation group was lower than the control group with statistically significant difference(P<0.05).There was no statistically difference in operation time,blood loss within postoperative 24 h,and hospital stay after cesarean section(P>0.05).There were no statistically significant differences between the two groups of neonates with Apgar scores of 1 minute,5 minutes,and neonatal birth weight(P>0.05).In the observation group,the radiation dose to the fetus was 2-19 m Gy,averaged 9.3±5.2 m Gy,and the abdominal aorta balloon was occluded for 3-33 minutes,with an average of 8.4±6.8 minutes.There were no maternal deaths in either group.One patient had a hematoma at the puncture site in the right inguinal region after surgery in the observation group which was improved after conservative treatment.All patients recovered well and the balloon group was followed up for 3 months without intervention-related complications.Conclusion ABO assists cesarean section for patients with PPP is safe and effective,which can reduce intraoperative blood loss and blood transfusion,reduce the risk of hysterectomy.??Comparison of abdominal aortic balloon occlusion with prophylactic uterine artery catheterization and embolization in treatment of pernicious placenta previaObjective To compare the clinical efficacy of temporary abdominal aortic balloon occlusion(ABO)with prophylactic uterine artery catheterization and embolization(UACE)for the management of pernicious placenta previa and accreta.Materials and methods A total of 70 patients with PPP and PA,who were admitted to our hospital during the period from January 2014 to December 2016,were included in this study.According to cesarean section involved in different intervention methods into two group.ABO in 36 cases as balloon group,UACE in 34 cases as embolization group.The intraoperative blood loss,intraoperative blood transfusion,blood loss within postoperative 24 h,operation time,hysterectomy rate,hospital stay after cesarean section,Apgar score and birth weight of the two groups were compared.Results The technical success rate of the two groups were 100%.There was no significant difference in the age,gestational week,pregnancy,parity,and placenta accreta between the two groups(P>0.05).Blood loss,the transfusion amount of red cell suspension,operation time and fetal radiation dose in the balloon group were lower than those in the embolization group with statistically significant difference(P< 0.05).There was no significant difference in the rate of hysterectomy,intraoperative bleeding within 24 hours,and postoperative hospital stay between the two groups(P>0.05).There were no statistically significant differences between the two groups of neonates with Apgar scores of 1 minute,5 minutes,and neonatal birth weight(P>0.05).There were no maternal deaths in either group.One patient had a hematoma at the puncture site in the right inguinal region after surgery in the balloon group which was improved after conservative treatment.10 cases of postoperative fever and 4 cases of lower abdominal pain in the embolization group.After a routine follow-up of 3 months,no intervention-related complications occurred.Conclusion ABO resulted in better clinical outcomes with less blood loss,intraoperative blood transfusion,operation time,foetal radiation dose than those in prophylactic uterine artery catheterization and embolization..