The intraoperative use of internal iliac artery balloon catheters in cesarean deliveries for abnormal invasive placentation: A 3-year retrospective cohort review in Doha, Qatar.
cesarean section
internal iliac artery balloon occlusion catheter
operative hemorrhage
placenta accreta spectrum
Journal
Qatar medical journal
ISSN: 0253-8253
Titre abrégé: Qatar Med J
Pays: Qatar
ID NLM: 8101648
Informations de publication
Date de publication:
2021
2021
Historique:
received:
29
06
2020
accepted:
07
09
2020
entrez:
8
4
2021
pubmed:
9
4
2021
medline:
9
4
2021
Statut:
epublish
Résumé
Abnormal invasive placentation leads to massive intraoperative hemorrhage and maternal morbidity. This study aimed to assess the impact of the preoperative use of internal iliac artery balloon occlusion (IIABO) catheters in patients who had a cesarean delivery (CD) for invasive placentation, commonly known as the placenta accreta spectrum. This retrospective cohort study reviewed 67 pregnancies complicated by abnormal invasive placenta and confirmed intraoperatively. Preoperative planned placement of IIABO was performed in 33 women who underwent elective CD. Senior Obstetricians with the necessary expertise performed all CDs. The primary outcome measures were: intraoperative blood loss, blood transfusion requirement, duration of surgery and the need for hemostatic measures. Univariate comparison between the groups and regression analysis of the primary outcome and controlling for confounders, were performed. No statistically significant difference was observed between the groups with intraoperative hemorrhage volume of above 3000 mL (unadjusted odds ratio [OR] 0.94 [no-IIABO group as the reference]; The placement of IIABO catheters is an invasive procedure, which consumes time and resources. Its value as a means of reducing intraoperative blood loss or preserving the uterus in patients with abnormal placental adherence appears questionable. In this cohort study, there was no statistical difference in blood loss, and the need for other steps to control hemorrhage between women with and without IIABO catheters.
Sections du résumé
BACKGROUND
BACKGROUND
Abnormal invasive placentation leads to massive intraoperative hemorrhage and maternal morbidity. This study aimed to assess the impact of the preoperative use of internal iliac artery balloon occlusion (IIABO) catheters in patients who had a cesarean delivery (CD) for invasive placentation, commonly known as the placenta accreta spectrum.
METHODS
METHODS
This retrospective cohort study reviewed 67 pregnancies complicated by abnormal invasive placenta and confirmed intraoperatively. Preoperative planned placement of IIABO was performed in 33 women who underwent elective CD. Senior Obstetricians with the necessary expertise performed all CDs. The primary outcome measures were: intraoperative blood loss, blood transfusion requirement, duration of surgery and the need for hemostatic measures. Univariate comparison between the groups and regression analysis of the primary outcome and controlling for confounders, were performed.
RESULTS
RESULTS
No statistically significant difference was observed between the groups with intraoperative hemorrhage volume of above 3000 mL (unadjusted odds ratio [OR] 0.94 [no-IIABO group as the reference];
CONCLUSIONS
CONCLUSIONS
The placement of IIABO catheters is an invasive procedure, which consumes time and resources. Its value as a means of reducing intraoperative blood loss or preserving the uterus in patients with abnormal placental adherence appears questionable. In this cohort study, there was no statistical difference in blood loss, and the need for other steps to control hemorrhage between women with and without IIABO catheters.
Identifiants
pubmed: 33828954
doi: 10.5339/qmj.2021.8
pii: qmj.2021.8
pmc: PMC7961153
doi:
Types de publication
Journal Article
Langues
eng
Pagination
8Informations de copyright
© 2021 Ahmed, Minisha, Babarinsa, Omar, Bayo, Omar, Farrell, licensee HBKU Press.
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