Prophylactic placement of balloon catheters or sheaths prior to planned cesarean delivery may reduce blood loss in women with placenta accreta spectrum disorder.
Prophylactic placement of balloon catheters or sheaths prior to planned cesarean delivery may reduce blood loss in women with placenta accreta spectrum disorder, according to a new systematic review of more than 5000 individuals.
More research is needed on intrapartum strategies to improve maternal outcomes, and prophylactic radiologic intervention to reduce perioperative blood loss has been explored, the researchers wrote. However, placenta accreta spectrum disorder remains relatively rare in most pregnancy settings, and data on the effect of prophylactic radiologic interventions to reduce bleeding in this high-risk population are limited they said.
Results were similar with lower blood loss for intervention patients compared with controls in subgroup analyses of different types of placenta accreta spectrum disorder and those with placenta accreta spectrum disorder confirmed post partum. Most of the studies did not report data on the researchers' predefined secondary outcomes, including shock, transfer to a higher level of care, coagulopathy, organ dysfunction, and patient-reported outcomes."Our main analysis reveals differences in outcomes among the three interventions, with proximal balloon occlusion demonstrating the strongest effect," the researchers wrote."Our results show a blood loss reduction of 406 mL by distal prophylactic balloon occlusion.
Uterine artery embolization after cesarean delivery also has been associated with reduced hemorrhage and no adverse events, but this procedure was not included in the studies reviewed and is best conducted in a delivery setup not available in many hospital systems, the editorialists noted.
Pregnant Blood Placenta Accreta Blood Transfusion Thromboembolism Cesarean Delivery Caesarean Delivery Cesarean Section Caesarean Section C-Section Uterine Womb Arteries Embolisation Embolization Pain Management Hemorrhage Bleeding Perioperative Postpartum Bleeding Postpartum Hemorrhage Postpartum Haemorrhage Transfusion Maternal Mortality Maternal Death
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