Role of vascular occlusion in the consequence of women with pernicious placenta previa and prior cesarean section
Vascular occlusion has been applied to reduce bleeding during the delivery (20–23) , which was verified in this study. Vascular occlusion was applied to 106 pregnancies by either uterine artery embolization or abdominal aorta balloon occlusion (blocking group). The other 641 cases were assigned as unblocked group. The basic information of patients in two groups was described in Table S2 and no significant difference was observed between two groups. However, more suspected placenta implantation was observed by ultrasound in the blocking group (26.4%) than that in the non-blocking group (15.9%). The bleeding volume during the delivery (600∼2500 vs . 500∼2000 ml, p=0.093) and the incidence of postpartum hemorrhage (63/106 vs 354/641 cases, p=0.419) were similar between blocking and non-blocking group. Surprisingly, the hysterectomy rate in blocking group (25.4%, 27/106 cases) was much higher than that in non-blocking patients (7.9%, 51/641 cases) (p<0.001). The effect of vascular occlusion on the fetal outcomes was also checked in this study. No differences were detected between blocking and non-blocking group, including the gestation terms of pregnancies and the Apgar score after birth (1 & 5 minutes) (Table S3).