| Placenta accreta: comparison of cases managed with and without pelvic artery balloon catheters. | |
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MedLine Citation:
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PMID: 10406301 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To describe our experience with the use of prophylactic pelvic artery balloon catheters in cases of placenta accreta diagnosed by antenatal ultrasound and to compare these cases with contemporary controls. METHODS: In this prospective study, all patients seen at our institution between January 1994 and August 1997 with the antenatal sonographic diagnosis of placenta accreta were offered prophylactic preoperative pelvic artery balloon catheterization. Patients who were delivered by cesarean hysterectomy for unsuspected placenta accreta in our institution during the same time interval served as controls. Five patients with the sonographic diagnosis of placenta accreta underwent prophylactic pelvic artery balloon catheterization. Surgical outcomes in patients who received balloon catheters were compared with those managed without them. Statistical analysis was performed using the Mann-Whitney U test. RESULTS: Five patients with placenta accreta or one of its variants were correctly identified with antenatal ultrasonography. Of the five patients who underwent pelvic artery balloon catheterization, all had placenta accreta and four required cesarean hysterectomy. The mean estimated blood loss, transfusion requirement, and length of hospitalization in patients undergoing hysterectomy managed with and without the balloon catheters was not different (P > 0.06). CONCLUSIONS: Antenatal sonographic diagnosis of placenta accreta enables preoperative planning. In our experience, use of pelvic artery balloon occlusion catheters in patients requiring a cesarean hysterectomy for placenta accreta did not improve surgical outcomes compared with patients managed without them. These preliminary findings are based on a small number of patients; therefore, further investigation is needed. |
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Authors:
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A B Levine; K Kuhlman; J Bonn |
Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: The Journal of maternal-fetal medicine Volume: 8 ISSN: 1057-0802 ISO Abbreviation: J Matern Fetal Med Publication Date: 1999 Jul-Aug |
Date Detail:
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Created Date: 1999-08-31 Completed Date: 1999-08-31 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9211288 Medline TA: J Matern Fetal Med Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 173-6 Citation Subset: IM |
Affiliation:
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Department of Obstetrics and Gynecology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Arteries Balloon Dilatation* Cesarean Section Disease Management Female Humans Pelvis / blood supply Placenta Accreta / diagnosis, therapy* Pregnancy Prenatal Diagnosis Prospective Studies Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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