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  • Title: Efficacy of temporary ligation of infrarenal abdominal aorta during cesarean section in pernicious placenta previa.
    Author: Huang S, Xia A, Jamail G, Long M, Cheng C.
    Journal: Zhong Nan Da Xue Xue Bao Yi Xue Ban; 2017 Mar 28; 42(3):313-319. PubMed ID: 28364106.
    Abstract:
    To evaluate the efficacy and safety of temporary loop ligation of the infrarenal abdominal aorta for control of intraoperative blood loss in patients with pernicious placenta previa.
 Methods: We retrospectively analyzed the clinical data of 14 patients with pernicious placenta previa, who underwent temporary loop ligation of the infrarenal abdominal aorta for control of blood loss during cesarean section between July 2013 and December 2014.
 Results: Eight patients received conservative management to preserve the uterus and 6 patients underwent cesarean hysterectomy. The occlusion time of the abdominal aorta was (31.42±12.67) min. The average estimated intraoperative blood loss was (1 117.85±745.13) mL. The volume of packed red blood cell transfusion was (3.91±3.24) units, and the volume of fresh frozen plasma transfusion was (192.85±156.71) mL. Post-operative histologic diagnosis revealed 6 cases of placenta percreta, 4 of increta, 3 of accreta and 1 non-creta. All patients experienced an uneventful postoperative recovery.
 Conclusion: In patients with pernicious placenta previa, temporary ligation of the infrarenal abdominal aorta provide a safe and effective means for controlling intraoperative hemorrhage during cesarean section. Additionally, the procedure may provide an opportunity to preserve fertility by avoiding a cesarean hysterectomy. 目的：探讨腹主动脉暂时阻断术在凶险型前置胎盘中的应用对控制产后出血的临床效果及安全性。
方法：回顾性分析中南大学湘雅三医院2013年7月至2014年12月14例凶险型前置胎盘在剖宫产术中行腹主动脉暂时阻断术的临床资料。结果：8例成功保留子宫，6例行子宫全切术，腹主动脉阻断时间(31.42±12.67) min，术中出血量为(1 117.85±745.13) mL，输血量为浓缩红细胞(3.91±3.24) U，冰冻血浆(192.85±156.71) mL。术后病理检查结果证实胎盘植入类型6例为穿透型，4例为植入型，3例为粘连型，1例无明显植入。所有患者术后恢复良好。结论：腹主动脉暂时阻断术是一种安全有效的应用于凶险型前置胎盘剖宫产术中止血的方法。该项技术可增加保留生育功能的概率，降低子宫切除率。.
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