Comparison Of Themporary Common Iliac Artery Occlusion With Badominal Aortic Occlusion For 30 Cases With Placenta Accreta

OBJECTIVE: To compare the clinical outcomes of temporary common iliac artery occlusion with abdominal aortic occlusion.METHODS: We selected 30 patients from January 2013 to January 2017 in the First Affiliated Hospital Of Guangxi Medical University with suspected placenta accreta prenatally,which underwent the preoperative prophylactic balloon.11 of them were common iliac artery occlusion(Group A),and 19 of them were abdominal aortic occlusion(Group B).Data about blood loss,blood transfusion,balloon occlusion time,morbidity of caesarean sections,complications,newborn outcomes and other datas were collected.RESULTS: Temporary common iliac artery occlusion and abdominal aortic occlusion were placed successfully in all patients.Patient demographics and baseline characteristics had no differences between the two groups statistically.Meanwhile there were no significantly differences between the A and B group with respect to the amount of blood loss(2009.5±1757.1 ml,1957±1673.3ml,P=0.94),red cell transfusion(9.6±8.6 u,9.4±8.4 u,P=0.95),plasmatransfusion(890.9±911.8 ml,665.8±840.8 ml,P=0.50),operation time(170.7±106.6 min,197.7±85.6 min,P=0.45),balloon occlusion time(58.5±39.9min,46.0±22.6 min,P=0.35),morbidity of caesarean sections(P=0.27,OR=2.6,95%CI 0.09-2.32),operation complications(P=0.25,OR=3.3,95%CI0.56-19.45),postoperation complications(P=0.1,OR=4.44,95%CI 0.80-24.61),length of stay(12.6±3.9 d,12.5±6.3 d,P=0.96),newborn length of stay(8.8±7.9 d,4.5±4.7 d,P=0.07),and some other datas.There were no cases dead in two groups.The time for placing balloons in Group B were much shorter than those in Group A.CONCLUSION: In the management of placenta accreta,the clinical outcomes for common iliac artery occlusion and abdominal aortic occlusion were similar.But the abdominal aortic occlusion may have shorter time for placing the balloon,and much easier,blind methods for placing balloon could avoid the radiation to the maternal and fetal.However,whether or not this way result in more complications are not clear.And we need more struggle to explore the usage for heparin and appropriate occlusion time.United all kinds of hemostatic ways may decrease the morbidity of hysterectomy.