Radiologic Intervention of Internal Iliac Artery Occlusion During Cesarean Section for Dangerous Placenta Previa

Abstract

Objective: The cesarean section of dangerous placenta previa always faces the problem of massive hemorrhage. The aim of this study was to analyze the clinical effect of internal iliac artery occlusion combined with obstetric autotransfusion in cesarean section of dangerous placenta previa. Method: From November 2017 to November 2019, 20 patients with placenta previa undergoing cesarean section in our hospital were selected. According to the preoperative MRI and ultrasound diagnosis, the amount of bleeding was evaluated and divided into observation group (n = 6) and control group (n = 14). All patients underwent routine cesarean section and prepared the obstetric autotransfusion device. In the observation group, the internal iliac artery balloon was placed under DSA before operation. After the fetus was taken out, the internal iliac artery was blocked. The internal iliac artery occlusion was not needed in the control group. The total length of stay, Apgar score, the incidence of disseminated intravascular coagulation (DIC), hemorrhagic shock, postoperative infection and renal dysfunction were compared between the two groups. Result: Compared with the relative data in control group, the operation time and postoperative hospital stay of the observation group were significantly shorter, the intraoperative blood loss and blood transfusion were significantly lesser, and the hemoglobin difference before and after operation was significantly lesser. There was no significant difference in the incidence of DIC, hemorrhagic shock, postoperative infection and renal dysfunction between two groups; There was no significant difference in neonatal body mass, Apgar score at 1 min and 5 min. Conclusion: The internal iliac artery occlusion can effectively reduce the amount of bleeding in delivery, promote the recovery of negligence, and have no adverse effect on complications and neonatal outcome.