Application of ultrasound-guided balloon occlusion in cesarean section in 130 cases of sinister placenta previa

Chen, Kunqian; Zhang, Guohui; Li, Fawang; Liu, Jianfeng; Xie, Kui; Zhu, Enquan; Li, Wenliang; Zhang, Mingli; Gen, Chao; Ai-guo, Wang

doi:10.1016/j.jimed.2020.01.006

Cited by 5 publications

(3 citation statements)

References 8 publications

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“…Because the specificity of medical images of PPP varies greatly, overdiagnosis or missed diagnosis sometimes occurs in clinical practice [ 18 ]. In recent years, it has been reported that the sensitivity, specificity, and positive predictive value of ultrasound in the diagnosis of PPP are 87%-95%, 76%-98%, and 82%-93%, respectively [ 19 ]. Ultrasound scoring combined with medical history was used for prenatal diagnosis of PPP and placenta accreta, and in 60 patients with PPP, 10, 17, 12, and 21 patients had severe, implantable, adhesive, and penetrating PPP, respectively.…”

Section: Discussionmentioning

confidence: 99%

Deep Learning Algorithm-Based Ultrasound Image Information in Diagnosis and Treatment of Pernicious Placenta Previa

Yang

Chen

Jia

2022

Computational and Mathematical Methods in Medicine

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This study was to explore the value of the deep dictionary learning algorithm in constructing a B ultrasound scoring system and exploring its application in the clinical diagnosis and treatment of pernicious placenta previa (PPP). 60 patients with PPP were divided into a low-risk group (severe, implantable) and high-risk group (adhesive, penetrating) according to their clinical characteristics, B ultrasound imaging characteristics, and postpartum pathological examination results. Under PPP ultrasonic image information using the deep learning algorithm, the B ultrasound image diagnostic scoring system was established to predict the depth of various types of placenta accreta. The results showed that the cut-off values of severe, implantable, adhesive, and penetrating types were <2.3, 2.3-6.5, 6.5-9, and ≥9 points, respectively; there were significant differences in the termination of pregnancy and neonatal birth weight between the two groups ( P < 0.05 ); the positive predictive value, negative predictive value, and false positive rate of ultrasound images based on the deep dictionary learning algorithm for PPP were 95.33%, 94.89%, and 3.56%, respectively. Thus, the ultrasound image diagnostic scoring system based on the deep learning algorithm has an important predictive role for PPP, which can provide a more targeted diagnosis and treatment plan for patients in clinical practice and improve the prediction and treatment efficiency.

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Section: Discussionmentioning

confidence: 99%

Deep Learning Algorithm-Based Ultrasound Image Information in Diagnosis and Treatment of Pernicious Placenta Previa

Yang

Chen

Jia

2022

Computational and Mathematical Methods in Medicine

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“…The radiation dose can be decreased with aortic occlusion but with an associated risk of severe complications 32 . Placement of the occlusion balloons in the common iliac arteries can be performed even without X-ray exposure under ultrasound guidance, but with a higher risk of thromboembolic complications and risks of retrograde flow into the internal iliac arteries 33 . Another disadvantage is an inability to continue with uterine artery embolization in indicated cases compared with the selective catheterization of the internal iliac arteries.…”

Section: Discussionmentioning

confidence: 99%

Estimating the radiation dose to the fetus during prophylactic internal iliac occlusion in patients with abnormal placentation

Černá¹,

Huml²,

Köcher³

et al. 2021

BIOMED PAP

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Aims. To evaluate the estimated fetal radiation dose during prophylactic internal iliac arterial occlusion in patients with abnormal placenta and to estimate the risk of radiation induced cancer in child age. Methods. Prophylactic occlusion of the internal iliac arteries during Caesarean section was performed in 42 patients with placenta praevia and/or placenta accreta spectrum. Fogarty embolectomy catheters were used for prophylactic occlusion of the internal iliac arteries. All procedures were performed in the hybrid operating room using Philips Allura Xper FD 20 X-ray system. Low dose X-ray fluoroscopy (7.5 frames per second) was used. The CODE (Conceptus dose estimation) Software was used to estimate the fetal dose and the risk of radiation induced carcinoma. Results. Fluoroscopy times required for insertion of Fogarty catheters were 0.5-4.2 min (mean: 1.7 min, median: 1.5 min). The estimated radiation dose to the fetus was 0.26-3.36 mGy (mean: 1.49 mGy, median: 1.25 mGy). The risk of radiation induced cancer in child age was 0.01-0.04% (mean 0.02%, median 0.01%). One patient developed thrombosis of a common femoral artery. Conclusion. Prophylactic occlusion of the internal iliac arteries is a simple and safe procedure with minimal risk of complications and with a very low estimated radiation dose to the fetus.

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“…This case series describes our experiences and technique of performing ultrasound (US)-guided prophylactic abdominal aortic balloon occlusion (PAABO) in PAS in the operating room, a procedure previously reported in small numbers in China only. [ 4 , 5 ]…”

Section: Introductionmentioning

confidence: 99%

Ultrasound-guided prophylactic abdominal aortic balloon occlusion for placenta accreta spectrum disorder: A case series

Grewal

Magro

Premnath

et al. 2023

JCIS

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Placenta accreta spectrum (PAS) disorder is one of the most dangerous conditions that can affect pregnancy and its incidence is increasing secondary to rising cesarean section rates worldwide. The standard treatment is frequently elective hysterectomy at the time of cesarean delivery; however, uterine and fertility preserving surgery is becoming more common. In the pursuit of a reduction in blood loss and associated maternal morbidity, occlusive vascular balloons are increasingly used at the time of surgery, usually placed with fluoroscopic guidance. Occlusive balloons placed in the infrarenal aorta have been shown in the literature to be superior in terms of blood loss and hysterectomy rates than those placed more distally, such as within iliac or uterine arteries. We present the first five cases performed in Europe of ultrasound-guided infrarenal aortic balloon placement before cesarean for PAS disorder, and describe the technique we used, which provided reduced blood loss, a clearer operating field and avoided fetal and maternal exposure to radiation and intravenous contrast.

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Application of ultrasound-guided balloon occlusion in cesarean section in 130 cases of sinister placenta previa

Cited by 5 publications

References 8 publications

Deep Learning Algorithm-Based Ultrasound Image Information in Diagnosis and Treatment of Pernicious Placenta Previa

Deep Learning Algorithm-Based Ultrasound Image Information in Diagnosis and Treatment of Pernicious Placenta Previa

Estimating the radiation dose to the fetus during prophylactic internal iliac occlusion in patients with abnormal placentation

Ultrasound-guided prophylactic abdominal aortic balloon occlusion for placenta accreta spectrum disorder: A case series

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