Application Value Of Forgarty Balloon Occlusion Of Abdominal Aorta Combined With Uterine Artery Embolization In Patients With Pernicious Placenta Previa

Objective:To explore and analyze the therapeutic effect of Forgarty balloon occlusion of abdominal aorta combined with uterine artery interventional embolization assisted cesarean section in women with pernicious placenta previa(PPP).Methods:The clinical data of 193 patients with dangerous placenta previa and cesarean section who were admitted to Yibin First People’s Hospital from January 2016 to August 2019 were retrospectively analyzed.According to whether the Forgarty balloon was used to block the abdominal aorta before cesarean section,the patients were divided into experimental group(n=91)and control group(n=102).The experimental group was divided into balloon group(n=43)and combined group(n=48)according to whether uterine artery embolization was performed after cesarean section.The general data of each group were retrospectively investigated:age,gestational age,gravidity,parity,number of previous cesarean sections;intraoperative indicators of cesarean section:cesarean section operation time,intraoperative blood loss,intraoperative major bleeding rate,blood transfusion volume,fluid volume,hysterectomy rate;indicators after cesarean section:postoperative blood transfusion volume,postoperative hospital stay,postoperative fever,DIC,postoperative hemorrhagic shock,postoperative ICU admission;Infant outcomes:neonatal 1-minute and 5-minute APGAR score,birth weight,whether or not to be transferred to the neonatology department;interventional surgery indicators:the pre-abdominal aortic balloon placement time,ionizing radiation dose,uterine artery embolization and embolization time in the experimental group.The clinical efficacy of the two groups was compared and analyzed.Results:1.The age,gestational age,gravidity,parity,and previous cesarean section times of the experimental group and control group(P=0.580,P=0.385,P=0.433,P=0.548,P=0.462)and other general information The comparison is not statistically significant;2.Intraoperative blood loss,intraoperative major bleeding rate,intraoperative blood product volume,intraoperative fresh frozen plasma volume,intraoperative red blood cell suspension volume,hysterectomy rate,postoperative blood product volume,intraoperative blood transfusion volume of experimental group The incidence of hemorrhagic shock,postoperative ICU admission rate,and postoperative hospitalization days(P<0.001,P=0.001,P=0.008,P=0.007,P<0.001,P<0.001,P<0.001,P=0.002)were significantly lower than those in the control group,and the difference was statistically significant(P<0.05).The cesarean section operation time,intraoperative fluid volume,postoperative fever rate,postoperative There was no significant difference in the incidence of DIC(P=0.245,P=0.084,P=0.097,P=0.675);3.In the experimental group,43 patients underwent Forgarty balloon occlusion of the abdominal aorta alone,and 48 patients underwent balloon occlusion combined with uterine artery embolization.The intraoperative blood transfusion volume and postoperative bleeding volume were significantly higher than those in the combined group(P=0.013,P<0.001,P=0.021),and the difference was statistically significant;,balloon catheterization time and blocking time,postoperative blood loss,postoperative blood transfusion volume,hysterectomy rate,1-minute and 5-minute APGAR score of neonates,birth weight,whether to transfer to the neonatology department,postoperative fever,and postoperative DIC,postoperative hemorrhagic shock,postoperative ICU admission and postoperative hospitalization time were not statistically significant(P>0.05);4.Neonatal outcome indicators:There was no significant difference in the 1-minute and 5-minute APGAR score,neonatal weight,and rate of transfer to neonatology between the two groups(P=0.615、P=0.636,P=0.613,P=0.674).Conclusion:Forgarty balloon occlusion of abdominal aorta combined with uterine artery embolization is safe and effective in cesarean section for dangerous placenta previa,which can significantly reduce blood loss during perioperative period,reduce hysterectomy rate,and reduce postoperative complications.Complications,shortened postoperative hospital stay,and will not adversely affect the fetus,it is worthy of clinical application.