Maternal outcomes of abnormally invasive placenta in China and their association with use of abdominal aortic balloon occlusion

Abstract

Objective

To compare maternal outcomes of abnormally invasive placenta in China in 2012, 2015, and 2018, and further examine the association between use of abdominal aortic balloon occlusion (AABO) and the risk of maternal outcomes.

Materials and methods

A retrospective analysis included 830 women diagnosed as abnormally invasive placenta from 5 tertiary care centers in China in 2012, 2015 and 2018. Participants were divided into AABO group and non-AABO group according to whether they were treated with AABO or not. Logistic regression models were used to assess the association of use of AABO with postpartum hemorrhage, blood transfusion, hysterectomy and repeated surgery.

Results

Among 830 participants, 66.0% (548/830) and 34.0% (282/830) of women were diagnosed with placenta increta and percreta, respectively; 33.3% (276/830) of women with abnormally invasive placenta were treated with AABO. In 2012, 2015, and 2018, the rate of blood transfusion was 83.1, 59.8, and 56.2%; the rate of hysterectomy was 50.8, 11.2, and 2.4%; and the rate of repeated surgery was 10.2, 9.4, and 0.9%. Use of AABO was associated with lower risk of postpartum hemorrhage (OR = 0.59, 95% CI: 0.35–0.99), blood transfusion (OR = 0.72, 95% CI: 0.52–0.99), hysterectomy (OR = 0.04, 95% CI: 0.01–0.14) and repeated surgery (OR = 0.14, 95% CI: 0.05–0.41) after adjustment for potential confounders.

Conclusion

The rates of blood transfusion, hysterectomy and repeated surgery progressively decreased from 2012 to 2018 in Chinese women with abnormally invasive placenta. Use of AABO was associated with lower risk of postpartum hemorrhage, blood transfusion, hysterectomy and repeated surgery.

Keywords:

• Placenta increta
• placenta percreta
• abnormally invasive placenta
• abdominal aortic balloon occlusion
• hysterectomy

Acknowledgements

We thank all participants and investigators and all staff of medical record section in 5 hospitals.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study was funded by the Scientific Research Seed Fund of Peking University First Hospital Project [2019SF37].