To investigate the clinical effects of abdominal aortic balloon occlusion followed by uterine artery embolization in the treatment of pernicious placenta previa complicated with placenta accrete during cesarean section.

A retrospective analysis of clinical data of 512 patients who suffered from pernicious placenta previa complicated with placenta accreta and received treatment in our hospital from January 2013 to December 2016 was carried out. All patients underwent abdominal aortic balloon implantation before cesarean section. 62 patients received bilateral uterine artery embolization, among them, the placenta accreta was found at the opening of the cervix in 4 cases. Due to the difficulty to suture after the removal of the placenta, gauze packing was used to compress hemorrhage temporarily. As soon as the uterus was sutured, emergent bilateral uterine artery embolization was performed. In the other 58 cases, there was still active bleeding when pressing the lower part of the uterus after the placenta was removed and the uterus was sutured, so bilateral uterine artery embolization was performed urgently. This study aims to investigate the clinical effects and complications of the 62 patients who received abdominal aortic balloon occlusion followed by uterine artery embolization.

Of all 512 patients, 450 patients received only abdominal aortic balloon occlusion; 62 patients underwent emergent bilateral uterine artery embolization additionally due to hemorrhage during or after the C-section. No hysterectomy was performed. Of the 62 patients, the amount of bleeding was 900~3 000 ml with an average of 1500 ml during the operation; the volume of blood transfusion was 350~1 600 ml with an average of 940ml. Fetal fluoroscopy time was 3~8 s with an average of 5 s. The dose of received radiation exposure was (4.2±2.9)mGy. Fetal Apgar score was normal. No serious complications were observed during and after the operation in follow-up visits.

For patients with pernicious placenta previa complicated with placenta accreta and suffering from active bleeding after cesarean section and abdominal aortic balloon occlusion, bilateral uterine artery embolization can effectively reduce blood loss and blood transfusion during the operation, as well as lower the risk of hysterectomy.