The application of the preset internal iliac artery balloon catheter and postoperative embolization in treating patients with pernicious placenta previa undergoing caesarean section

Abstract

Objective: To evaluate the clinical value of the preset internal iliac artery balloon catheter and postoperative embolization in treating patients with pernicious placenta previa undergoing caesaren section. Methods: 168 patients with pernicious placenta previa were selected, among which, 104, as the observation group, were preset with bilateral internal iliac artery balloon catheter, followed by cesarean section. After cesarean section, these women underwent bilateral internal iliac artery embolization. In another group, the remaining 64 patients received regular cesarean section as the control group. The clinical data of two groups , including the time for caesarean section, the amount of blood loss during operation, the amount of blood loss within 24 hours after operation, postoperative hospital stay and the hysterectomy rate were analyzed and compared. Results: In the observation group, all patients obtained satisfactory results. No serious complications, such as lower limb arterial thrombosis and the iliac artery aneurysm, occurred. The time for operation ranged at (75.8±19.5) min, the amount of blood loss during operation and within 24 hours reached to (1148.0±1142.8) ml, and (1468.4±1236.4) ml, respectively, the hospital stay after operation averaged at (6.9±1.6) days and the hysterectomy occurred in 6 patients (9.4%) . In the control group, the time for operation ranged at (136.8±27.6) min, the amount of blood loss during operation and within 24 hours reached to (3054.7±1644.7) ml, and (4653.2±1725.1) ml, respectively, the hospital stay after operation averaged at (10.2±1.7) days and the hysterectomy occurred in 10 patients (18%) with a significant statistical difference (P<0.05) . Among the 16 hysterectomy patients, 6 from the observation group were associated with placenta increta, and the placenta penetrating through myometrium to percreta, making it untearable, while in the .control group of 10 hysterectomies, 7 cases were associated with placenta increta, 3 associated with uterine contractions fatigue. Conclusion: For patients with pernicious placenta previa, the temporary balloon occlusion of the internal iliac artery in cesarean section is a safe and effective technique, which can reduce the relative complications, such as the volume of bleeding and the risk of hysterectomy, thus, it can be used as a feasible method. Key words: Pernicious placenta previa; Internal iliac artery occlusion; Arterial embolism