Abstract
BackgroundThe placenta accreta spectrum (PAS) is a severe complication of pregnancy and is associated with massive haemorrhage, hysterectomy, and even perinatal maternal-foetal death. Prophylactic abdominal aortic balloon occlusion (PAABO) is a novel and efficient therapy for these patients. The aim of this study was to investigate the benefits, potential risks, and characteristics of anaesthesia management.MethodsA total of 48 parturients with PAS were enrolled and divided into two groups. Group A (n = 25) received PAABO, and Group B (n = 23) underwent a normal operative procedure. The characteristics of the general parameters, anaesthesia, and operative procedure were noted. Data on vital signs including systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) during the operation were recorded. Before and after the procedure, hepatic and renal function and lactate dehydrogenase (LDH) were also measured.ResultsThe characteristics of the groups were comparable. PAABO significantly reduced estimated blood loss, which was ≥ 1000 ml. Drastic fluctuations in SBP, DBP and HR were observed during inflation and deflation in Group B. After the operation, increased LDH and glutamic oxaloacetic transaminase (GOT) were observed in both groups, and increased glutamic-pyruvic transaminase (GTP) was observed in Group B.ConclusionsPAABO reduced perioperative blood loss and the risk of hysterectomy among parturients with PAS. Sophisticated anaesthetic management should be implemented to prevent or reduce perioperative complications and address internal disorders that are caused by massive blood loss.
Highlights
The placenta accreta spectrum (PAS) is a severe complication of pregnancy and is associated with massive haemorrhage, hysterectomy, and even perinatal maternal-foetal death
Written informed consent was obtained from each parturient before enrollment in the study according to the process of informed consent by the Institutional Ethics Committee of Anhui Women and Child Health Care Hospital
We found that compared with baseline values, the mean systolic blood pressure (SBP) level was elevated by 16.43 mmHg in Group A and 2.26 mmHg in Group B at T2 (1 min after balloon inflation)
Summary
The placenta accreta spectrum (PAS) is a severe complication of pregnancy and is associated with massive haemorrhage, hysterectomy, and even perinatal maternal-foetal death. The incidence of PAS in parturients with second pregnancies and a history of CS has gradually increased in recent years [4]. Hysterectomy is often inevitable due to life-threatening bleeding This treatment reduces maternal mortality, it results in infertility, which is difficult for most Chinese patients and their families to accept [5].
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