Efficacy and safety of prophylactic abdominal aortic balloon occlusion versus internal iliac arterial balloon occlusion for placenta accreta spectrum disorder: A systematic review and meta-analysis
| Autor: | Chuan Liu, Hai-bo Qu, Yi Guo, Ling-jun Liu, Dan-dan Yang |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Placenta accreta Placenta Accreta Cochrane Library Hysterectomy Iliac Artery 030218 nuclear medicine & medical imaging law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Pregnancy Occlusion medicine Humans Radiology Nuclear Medicine and imaging Spectrum disorder Aorta Abdominal Retrospective Studies business.industry Cesarean Section Balloon Occlusion Intraoperative Hemorrhage medicine.disease Surgery Balloon occlusion 030220 oncology & carcinogenesis Meta-analysis Female business |
| Zdroj: | Clinical imaging. 78 |
| ISSN: | 1873-4499 |
| Popis: | To assess the efficacy and safety of abdominal aortic (AA) balloon occlusion versus internal iliac arteries (IIA) balloon occlusion in patients with placenta accreta spectrum (PAS) disorders.Databases of Embase, PubMed, Web of Science and Cochrane Library were systematically searched from inception to May 2020. The relevant literature was screened and the quality was assessed. RevMan software 5.3 was used to analyze the data.Six studies involving 239 patients in AA occlusion and 281 patients in IIA occlusion were included. The results demonstrated that the intraoperative hemorrhage volume (MD - 410.61 ml, 95% CI -779.74 to -41.47 ml, p 0.001), balloon dilatation duration (MD -5.34 min, 95% CI -9.91 to -0.77 min, p = 0.02) and fetus radiation dose (MD-20.81 mGy, 95% CI -31.84 to -9.78 mGy, p 0.001) were significantly less in AA occlusion compared to IIA occlusion. There was no significant difference in the rate of lower extremity thrombosis between AA occlusion and IIA occlusion (OR 0.21, 95% CI 0.02 to 2.21, p = 0.19); similarly, no significant differences were found in blood transfusion volume (MD -344.50 ml, 95% CI -735.74 to 46.74 ml, p = 0.08), the rate of hysterectomy (OR 0.99, 95% CI 0.22 to 4.44, p = 0.99) and other outcome variables.The available data demonstrated AA occlusion was more effective in reducing intraoperative hemorrhage volume and fetus radiation dose compared with IIA occlusion in patients with PAS disorders. Larger studies or randomized controlled trials are needed to further assert this evidence. |
| Databáze: | OpenAIRE |
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