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.
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.
CONCLUSIONS: 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.
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.
CONCLUSIONS: 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.
摘要：
目的：比较中国2012年、2015年和2018年异常侵入性胎盘的产妇结局，并进一步研究腹主动脉球囊闭塞（AABO）的使用与产妇结局风险之间的关系。
方法：回顾性分析包括2012年、2015年和2018年来自中国5个三级护理中心的830名被诊断为异常侵入性胎盘的妇女。根据是否接受AABO治疗分为AABO组和非AABO组。采用Logistic回归模型评估AABO用药与产后出血的关系,输血,子宫切除术和重复手术。
结果：在830名参与者中，66.0％（548/830）和34.0％（282/830）的女性被诊断为胎盘植入和穿孔，分别;33.3%(276/830)的异常浸润性胎盘女性接受AABO治疗。2012年、2015年和2018年，输血率为83.1、59.8和56.2％；子宫切除率为50.8、11.2和2.4％；重复手术率为10.2、9.4和0.9％。使用AABO与降低产后出血风险相关(OR=0.59,95%CI:0.35-0.99),输血（OR=0.72，95%CI：0.52-0.99），子宫切除术（OR=0.04，95％CI：0.01-0.14）和重复手术（OR=0.14，95％CI：0.05-0.41）后调整潜在的混杂因素。
结论：输血率，从2012年到2018年，中国患有异常浸润性胎盘的女性子宫切除术和重复手术逐渐减少。使用AABO与产后出血的风险较低相关，输血,子宫切除术和重复手术。
方法：回顾性分析包括2012年、2015年和2018年来自中国5个三级护理中心的830名被诊断为异常侵入性胎盘的妇女。根据是否接受AABO治疗分为AABO组和非AABO组。采用Logistic回归模型评估AABO用药与产后出血的关系,输血,子宫切除术和重复手术。
结果：在830名参与者中，66.0％（548/830）和34.0％（282/830）的女性被诊断为胎盘植入和穿孔，分别;33.3%(276/830)的异常浸润性胎盘女性接受AABO治疗。2012年、2015年和2018年，输血率为83.1、59.8和56.2％；子宫切除率为50.8、11.2和2.4％；重复手术率为10.2、9.4和0.9％。使用AABO与降低产后出血风险相关(OR=0.59,95%CI:0.35-0.99),输血（OR=0.72，95%CI：0.52-0.99），子宫切除术（OR=0.04，95％CI：0.01-0.14）和重复手术（OR=0.14，95％CI：0.05-0.41）后调整潜在的混杂因素。
结论：输血率，从2012年到2018年，中国患有异常浸润性胎盘的女性子宫切除术和重复手术逐渐减少。使用AABO与产后出血的风险较低相关，输血,子宫切除术和重复手术。
