Abdominal Aortic Occlusion by Forgarty Catheter Combined with Uterine Artery Embolization in Application of Cesarean Section for Patients with Pernicious Placenta Previa

HUANG Zhi-yong; JIANG Qin; LI Zhao-hui; GUO Wei-chang; PENG Yi

doi:10.3969/j.issn.1002-3429.2017.07.021

Abstract：Objective To observe efficacy and safety of abdominal aortic occlusion by Forgarty catheter combined with uterine artery embolization in application of cesarean section for patients with pernicious placenta previa.Methods A total of 22 patients with pernicious placenta previa undergoing cesarean section from March to November 2016 were recruited as study group.Preoperative Forgarty catheterization was performed for all patients, and abdominal aorta was obstructed after fetal disengagement, and then uterine artery embolization was performed.Other 28 patients with pernicious placenta previa undergoing traditional cesarean section from January to December 2015 were selected as control group.Intraoperative blood loss volume, blood transfusion volume, neonatal Apgar score, radiation dose of ionizing radiation during Forgarty catherization and uterine artery embolization, postoperative length of stay, whether or not admission in ICU and perioperative incidence rate of complications were retrospectively investigated in two groups.With postoperative 3 months of follow-up, menstrual recovery time and incidence rates of radiation-related diseases in puerperal and neonatus were also observed.Results In study group, 21 patients had satisfactory hemostatic efficacy, while 1 patient had intraoperative hemorrhoea.In two groups, values of intraoperative blood loss volume were (354.1 ± 156.4) ml vs (2055.4 ± 567.3) ml;volume values of erythrocyte suspension consumption were (0.7 ± 0.3) U vs (4.2 ± 2.8) U;values of plasma consumption were (275.6±75.1) ml vs (890.6±245.1) ml;the total operative times were (78.2±25.5)min vs (133.4±29.2) min;postoperative length of stay were (7.4±2.1) d vs (14.5±2.6) d;hysterectomy rates were 0 vs 32.14%;admission rates in ICU were 0 vs 42.86%;intraoperative hemorrhoea rates were 4.55% vs 89.29%;hemorrhagic shock rates were 0 vs 39.29%, and the differences were statistically significant (P<0.05).In study group during postoperative 3 months of follow-up, no severe complications and radiation-related diseases in puerperal and neonatus were found, except that hip pain happened in 2 patients.Conclusion Abdominal aortic occlusion by Forgarty catheter combined with uterine artery embolization in assistance of cesarean section for patients with pernicious placenta previa is safe and effective, and it can significantly decrease incidence rates of postoperative hemorrhage and reduce incidence rate of adverse events such as hysterectomy.