Endovascular interventional modalities for haemorrhage control in abnormal placental implantation deliveries: a systematic review and meta-analysis

Endovascular interventional modalities for haemorrhage control in abnormal placental implantation... Objectives To examine the evidence regarding the effectiveness and safety of endovascular interventional modalities for haem- orrhage control in abnormal placentation deliveries. Methods MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched from inception to July 2017. Blood loss volume was regarded as the primary endpoint. Other important results are described. Random and fixed effects models were used for the meta-analysis. Results Of 385 studies identified, 69 (1,811 patients, mean age 32.9 years, range 23–39 years) were included. Mean gestational age at delivery was 35.1 weeks (range 27–38 weeks). Of 1,395 patients who underwent endovascular intervention, 587 (42%) had placenta accreta, 254 (18%) placenta increta and 313 (22%) placenta percreta. Prophylactic balloon occlusion of the internal iliac arteries (PBOIIA) was performed in 470 patients (33.6%), of the abdominal aorta (PBOAA) in 460 patients (33%), of the uterine artery (PBOUA) in 181 patients (13%), and of the common iliac arteries (PBOCIA) in 21 patients (1.5%). Primary embolization of the UA was performed in 246 patients (18%), of the pelvic collateral arteries in 12 patients (0.9%), and of the anterior division of the IIA in 5 patients (0.3%). Follow-up ranged from 0.5 to 42 months. Endovascular intervention http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png European Radiology Springer Journals

Endovascular interventional modalities for haemorrhage control in abnormal placental implantation deliveries: a systematic review and meta-analysis

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Publisher
Springer Berlin Heidelberg
Copyright
Copyright © 2018 by European Society of Radiology
Subject
Medicine & Public Health; Imaging / Radiology; Diagnostic Radiology; Interventional Radiology; Neuroradiology; Ultrasound; Internal Medicine
ISSN
0938-7994
eISSN
1432-1084
D.O.I.
10.1007/s00330-017-5222-0
Publisher site
See Article on Publisher Site

Abstract

Objectives To examine the evidence regarding the effectiveness and safety of endovascular interventional modalities for haem- orrhage control in abnormal placentation deliveries. Methods MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched from inception to July 2017. Blood loss volume was regarded as the primary endpoint. Other important results are described. Random and fixed effects models were used for the meta-analysis. Results Of 385 studies identified, 69 (1,811 patients, mean age 32.9 years, range 23–39 years) were included. Mean gestational age at delivery was 35.1 weeks (range 27–38 weeks). Of 1,395 patients who underwent endovascular intervention, 587 (42%) had placenta accreta, 254 (18%) placenta increta and 313 (22%) placenta percreta. Prophylactic balloon occlusion of the internal iliac arteries (PBOIIA) was performed in 470 patients (33.6%), of the abdominal aorta (PBOAA) in 460 patients (33%), of the uterine artery (PBOUA) in 181 patients (13%), and of the common iliac arteries (PBOCIA) in 21 patients (1.5%). Primary embolization of the UA was performed in 246 patients (18%), of the pelvic collateral arteries in 12 patients (0.9%), and of the anterior division of the IIA in 5 patients (0.3%). Follow-up ranged from 0.5 to 42 months. Endovascular intervention

Journal

European RadiologySpringer Journals

Published: Feb 5, 2018

References

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