Effect Of Intra-aortic Abdominal Aortic Balloon Implantation On Bleeding And Renal Function In Patients Having Pernicious Placenta Previa With Placenta Accreta

Objective:To investigate the effects of intra-aortic balloon occlusion on the volume of blood loss,the rate of hysterectomy and the renal function in pernicious placenta previa with placenta accret.Methods:A retrospective study from January 2014 and June 2017 consisting of 148 inpatients diagnosed of pernicious placenta previa with placenta accreta.The patients receiving cesarean section followed prophylactic abdominal aortic balloon occlusion were divided into study group(75 cases)and the patients having no intra-aortic abdominal aortic balloon implantation device implanted were divided into control group(73 cases).The following clinical parameters were compared in two groups:the general condition of the patient,estimated blood loss,transfused blood products,the rate of hysterectomy,operating time,uric acid,serum creatinine and urea.Results:The mean estimated blood loss,blood transfusion volume and the rate of hysterectomy in study group were lower than those in the control group,with a statistically significant difference(P<0.05).No statistical difference was observed in Apgar Scores of postnatal after 1 or 5 min between two groups(P>0.05).Intragroup comparsion:there was significiant degree of elevation in the post-operative levels of uric acid,creatinine and urea than the elevation seen pre-operatively.Compasion between groups:except for the 48 h post-operative uric and levels of study group which were lower than that of the control group,after the 48 h time period there was no significant different in the three indices among the two groups.More over the study group did not show any significant renal funtion impairment,the uric acid,creatinine and urea levels were within the normal limits.Conclusion:In patients having pernicious placenta previa with placenta accreta,preoperative intra-aortic balloon implant and temporary occlusion of the abdominal aorta during the operation can significantly reduce the blood loss,blood transfusion,the rate of hysterectomy without significant renal function impairment.Intra-operative abdominal aortic occlusion is a safe technique for patients having pernicious placenta previa with placenta accreta undergoing cesarean section.