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Prophylactic abdominal aortic balloon occlusion in patients with pernicious placenta previa during cesarean section: a systematic review and meta-analysis from randomized controlled trials

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Abstract

Purpose

Pernicious placenta previa induces severe hemorrhage during cesarean section. Abdominal aorta balloon occlusion (AABO) is considered as an effective operation for patients with pernicious placenta previa. The aim of this study was to investigate the clinical application of abdominal aortic balloon occlusion in the placenta previa and cesarean section by systematic review and meta-analysis.

Methods

MEDLINE, EMBASE, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), WAN-FANG DATA and CQVIP were searched from inception to Jan. 15th, 2019. Operative time, intraoperative blood loss volume, postoperative hospitalization duration, intraoperative blood transfusion volume, hysterectomy rate, lower extremity thrombosis rate, ICU admission rate, adverse reaction rate, neonatal birth weight, Apgar 1-min and 5-min scores were regarded as the endpoints. Randomized controlled trials (RCT) were used for meta-analysis.

Results

Fourteen articles were retrieved from total 650 articles, and the results of meta-analysis showed that application of intraoperative AABO had the ability to reduce the operative time (WMD = − 16.581, 95% CI − 26.690 to − 6.472; P = 0.001), the intraoperative blood loss volume (WMD = − 1202.69, 95% CI − 1732.25 to − 673.12; P < 0.001), the intraoperative blood transfusion volume (WMD = − 1202.69, 95% CI − 1732.25 to − 673.12; P < 0.001). The hysterectomy rate (RR = 0.279, 95% CI 0.164–0.474; P < 0.001), postoperative hospitalization duration (WMD = − 1.423, 95% CI − 2.070 to − 0.776; P < 0.001) and the balloon preset time (WMD = − 13.793, 95% CI − 15.341 to − 12.244; P < 0.001; I2 = 0.0%) were also reduced in AABO group.

Conclusions

Application of AABO in patients with pernicious placenta previa is safe and effective, which is worthy of clinical promotion.

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Funding

This study was supported by Guizhou Joint Science and Technology Fund LH Zi (2016_7157).

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Authors and Affiliations

  1. Department of Interventional Radiology, Guizhou Provincial People’s Hospital, No. 83 Zhongshan East Road, Guiyang, 550002, Guizhou, People’s Republic of China

    Qiang He, Ying-long Li, Xiao-chun Peng, Xiao-yan Liu, Hong-li Hou & Zun-zhong Pang

  2. Department of Obstetrics, Guizhou Provincial People’s Hospital, Guiyang, 550002, Guizhou, People’s Republic of China

    Ming-juan Zhu

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  1. Qiang He
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Contributions

QH and ZP: conceptualization, data curation, formal analysis, investigation, methodology, supervision, original draft writing, review and editing. YL and MZ: data curation, validation, formal analysis, original draft writing, review and editing. XP: supervision, review and editing. XL: validation, original draft writing, review and editing. HH: supervision, validation, review and editing. ZP acquired and administrated the funding. All the authors have read, reviewed critically and approved the final manuscript.

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Correspondence to Zun-zhong Pang.

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He, Q., Li, Yl., Zhu, Mj. et al. Prophylactic abdominal aortic balloon occlusion in patients with pernicious placenta previa during cesarean section: a systematic review and meta-analysis from randomized controlled trials. Arch Gynecol Obstet 300, 1131–1145 (2019). https://doi.org/10.1007/s00404-019-05297-4

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