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Prophylactic placement of internal iliac artery balloon catheters cannot improve outcomes of patients with abnormal invasive placenta
Abstract Number: T-50
Abstract Type: Original Research
Background: Prophylactic placement of internal iliac artery balloon catheters (IIABC) was initiated in our institute at November 2014. The objective of this study was to evaluate whether this procedure improved outcomes of women with abnormal invasive placenta (AIP).
Methods: From November 2013 to October 2014, all the patients with a prenatal diagnosis of AIP received prophylactic placement of IIABC and were identified as the study cohort (Group IIABC). Prenatally-diagnosed AIP patients in the preceding 12 months (from October 2012 to October 2013), who received the same standard treatment but no balloon catheters, were analyzed and served as a historic control (Group CON).
Results: Totally eligible 41 patients were identified in our database. 30 of the subjects received prophylactic balloon catheter and the balloons were inflated in 27 of the 30 cases. There were 11 subjects in group CON. Maternal demographic characteristics were similar between the two groups. There was no difference in estimated intraoperative blood loss (p = 0.636) or the incidence of intraoperative blood transfusion (p = 0.655) between the two groups. There was no difference in requirement of postoperative transfusion, either. Balloon catheter insertion failed to reduced cesarean hysterectomy (27.3% in group CON versus 43.3% in group IIABC, p = 0.478; RR = 2.039 [CI: 0.45-9.273]). However, balloon catheter insertion was associated with a slightly shortened hospital stay (5 [4-6] days versus 6 [5-7] days, p = 0.033, data were expressed as median [interquartile range]). No maternal or fetal complication was found with the insertion of balloon catheters.
Conclusions: Prophylactic balloon occlusion of internal iliac arteries was a safe procedure for both pregnant women and fetus. However, it had no effect on reducing intraoperative hemorrhage or cesarean hysterectomy in patients with AIP undergoing cesarean section. It seemed to reduce the length of postoperative hospital stay.