Abstract：
OBJECTIVE: The present study aims to compare prophylactic common iliac artery (CIA) temporary clamping and preoperative balloon occlusion for managing placenta accreta spectrum (PAS) disorders.
METHODS: Between January 2019 and June 2020, 46 patients with PAS disorders were included. Of them, 26 patients were offered CIA balloon occlusion (Group A), while temporary CIA clamping was done for the other 20 patients (Group B). Primary outcomes were procedure-related complications, and secondary outcomes included intraoperative and postoperative complications, reoperation rates, total procedure time, blood loss, and amount of blood transfusion.
RESULTS: Blood loss was statistically non-significant higher in group B than in group A (p-value = 0.143). Only one patient in group A and three in group B needed reoperation. The bleeding continued for a mean of 1.6 days in group A and 1.7 days in group B, with non-significant statistical differences between both groups p value = 0.71. Nine patients in group A (34.6%) and four in group B (20%) required ICU admission. The mean Apgar score was 7 and 6.6 in babies of group A and group B patients, respectively. The median number of allogeneic blood transfusions performed was two in patients in group A and 1 in group B (p-value = 0.001).
CONCLUSIONS: Both techniques offer good choices for patients with PAS to decrease mortality and morbidity rates. The selection of a better technique depends on institutional references and physicians\' experience.
METHODS: Between January 2019 and June 2020, 46 patients with PAS disorders were included. Of them, 26 patients were offered CIA balloon occlusion (Group A), while temporary CIA clamping was done for the other 20 patients (Group B). Primary outcomes were procedure-related complications, and secondary outcomes included intraoperative and postoperative complications, reoperation rates, total procedure time, blood loss, and amount of blood transfusion.
RESULTS: Blood loss was statistically non-significant higher in group B than in group A (p-value = 0.143). Only one patient in group A and three in group B needed reoperation. The bleeding continued for a mean of 1.6 days in group A and 1.7 days in group B, with non-significant statistical differences between both groups p value = 0.71. Nine patients in group A (34.6%) and four in group B (20%) required ICU admission. The mean Apgar score was 7 and 6.6 in babies of group A and group B patients, respectively. The median number of allogeneic blood transfusions performed was two in patients in group A and 1 in group B (p-value = 0.001).
CONCLUSIONS: Both techniques offer good choices for patients with PAS to decrease mortality and morbidity rates. The selection of a better technique depends on institutional references and physicians\' experience.
摘要：
目的：本研究旨在比较预防性髂总动脉（CIA）临时夹闭和术前球囊闭塞治疗胎盘植入谱（PAS）疾病。
方法：在2019年1月至2020年6月之间，纳入了46例PAS障碍患者。其中,26例患者接受了CIA球囊闭塞（A组），而对其他20例患者进行了颞叶CIA夹闭（B组）。主要结果是手术相关并发症，次要结局包括术中和术后并发症，再操作率,总手术时间,失血,和输血量。
结果：B组的失血量在统计学上比A组高（p值=0.143）。A组仅1例，B组仅3例需要再次手术。A组出血持续1.6天,B组平均1.7天,两组之间无显著统计学差异p值=0.71。A组9例（34.6％）和B组4例（20％）需要入住ICU。A组和B组患儿的平均Apgar评分分别为7分和6.6分,分别。A组患者进行同种异体输血的中位次数为2次，B组为1次（p值=0.001）。
结论：两种技术都为PAS患者提供了良好的选择，以降低死亡率和发病率。选择更好的技术取决于机构参考和医生的经验。
方法：在2019年1月至2020年6月之间，纳入了46例PAS障碍患者。其中,26例患者接受了CIA球囊闭塞（A组），而对其他20例患者进行了颞叶CIA夹闭（B组）。主要结果是手术相关并发症，次要结局包括术中和术后并发症，再操作率,总手术时间,失血,和输血量。
结果：B组的失血量在统计学上比A组高（p值=0.143）。A组仅1例，B组仅3例需要再次手术。A组出血持续1.6天,B组平均1.7天,两组之间无显著统计学差异p值=0.71。A组9例（34.6％）和B组4例（20％）需要入住ICU。A组和B组患儿的平均Apgar评分分别为7分和6.6分,分别。A组患者进行同种异体输血的中位次数为2次，B组为1次（p值=0.001）。
结论：两种技术都为PAS患者提供了良好的选择，以降低死亡率和发病率。选择更好的技术取决于机构参考和医生的经验。
