The Effect Prophylactic Internal Iliac Artery Balloon Occlusion in Patients with Placenta Previa or Placental Accreta Spectrum: a Systematic Review and Meta-analysis

Overview

Journal Reprod Biol Endocrinol

Publisher Biomed Central

Specialties Endocrinology
Reproductive Medicine

Date 2021 Mar 5

PMID 33663536

Citations 5

Authors

Anisodowleh Nankali

Nader Salari

Mohsen Kazeminia

Masoud Mohammadi

Samira Rasoulinya

Melika Hosseinian-Far

Affiliations

Soon will be listed here.

Abstract

Background: Placenta previa describes a placenta that extends partially or completely over the internal cervical oss. Placenta previa is one of the leading causes of widespread postpartum hemorrhage and maternal mortality worldwide. Another cause of bleeding in pregnant women is Placenta accreta spectrum. Therefore, the aim of the present systematic review and meta-analysis is to determine the effect of prophylactic balloon occlusion of the internal iliac arteries in patients with placenta previa or placental accreta spectrum (PAS).

Methods: In this systematic review and meta-analysis, to identify and select relevant studies, the SID, MagIran, ScienceDirect, Embase, Scopus, PubMed, Web of Science, and Google Scholar databases were searched, using the keywords of internal iliac artery balloon, placenta, previa, balloon, accreta, increta and percreta, without a lower time limit and until 2020. The heterogeneity of the studies was examined using the I index, and subsequently a random effects model was applied. Data analysis was performed within the Comprehensive Meta-Analysis software (version 2).

Results: In the review of 29 articles with a total sample size of 1140 in the control group, and 1225 in the balloon occlusion group, the mean difference between the two groups was calculated in terms of Intraoperative blood loss index (mL) and it was derived as 3.21 ± 0.38; moreover, in 15 studies with a sample size of 887 in the control group, and 760 in the balloon occlusion group, the mean difference between the two groups in terms of gestation index (weeks) was found as 2.84 ± 0.49; and also with regards to hysterectomy balloon occlusion after prophylactic closure of the iliac artery, hysterectomy (%) balloon occlusion was calculated as 8.9 %, and this, in the hysterectomy control group (%) was obtained as 31.2 %; these differences were statistically significant and showed a positive effect of the intervention (P < 0.05).

Conclusion: The results of this study show that the use of prophylactic internal iliac artery balloon occlusion in patients with placenta previa or Placenta accreta spectrum has benefits such as reduced intraoperative blood loss, reduced hysterectomy and increased gestation (weeks), which can be considered by midwives and obstetricians.

Citing Articles

Placenta Accreta: A Case Report on the Role of Interventional Radiology.

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Current state of interventional procedures to treat pernicious placenta previa accompanied by placenta accreta spectrum: A review.

Zhao H, Wang Q, Han M, Xiao X Medicine (Baltimore). 2023; 102(37):e34770.

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Postpartum hemorrhage - what the interventional radiologist should know.

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Prophylactic Intraoperative Uterine Artery Embolization During Cesarean Section or Cesarean Hysterectomy in Patients with Abnormal Placentation: A Systematic Review and Meta-Analysis.

Yang C, Chou Y, Kuo T, Liou J, Cheng H, Kuo Y Cardiovasc Intervent Radiol. 2021; 45(4):488-501.

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