Efficacy and safety of uterine artery ligation and occlusion combined with intrauterine packing in planned cesarean section for invasive and dangerous placenta previa
Objective To investigate the efficacy and safety of uterine artery ligation and occlusion combined with uterine packing in planned cesarean section for invasive and dangerous placenta previa.Methods From December 2019 to December 2021,132 cases of patients treated with planned cesarean section for invasive and dangerous placenta previa admitted to Tangshan Maternal and Child Health Hospital were selected as the research objects.They were divided into the uterine artery embolization combined with intrauterine packing treatment group(control group)and uterine artery ligation combined with intrauterine packing treatment group(observation group)according to different vascular occlusion methods.The operation time,intraoperative blood loss,intraoperative blood transfusion volume,and bladder injury rate of patients were observed and compared between the groups.Maternal and infant outcomes in the two groups were observed and recorded,including the 1-minute Apgar score of newborns,hysterectomy rate,and incidence of coagulation dysfunction.Postoperative adverse reactions in patients,including fever,chronic pelvic pain,poor wounds healing,postoperative thrombosis formation,decreased menstrual flow were recorded.Results The operation time and bladder injury rate in the observation group were lower than those in the control group(t=4.428 and 5.621,respectively,P＜0.05),while there was no significant difference in intraoperative blood loss and intraoperative blood transfusion volume between the two groups(t=1.472 and 1.729,respectively,P＞0.05).There was no significant difference in the 1-minute Apgar score of newborns between the two groups(t=0.257,P＞0.05).However,the hysterectomy rate and the incidence of coagulation dysfunction in the observation group were significantly lower than those in the control group(t=3.722 and 4.628,respectively,P＜0.05).No serious obstetric complications occurred in the two groups.Among them,the incidence rates of fever,chronic pelvic pain,postoperative thrombosis formation,poor wound healing,and decreased postoperative menstrual flow in the observation group were all significantly lower than those in the control group,with statistically significant differences(t=6.274,4.726,3.872,3.872 and 4.218,respectively,P＜0.05).Conclusion Both uterine artery ligation and uterine artery embolization have certain clinical efficacy for patients with invasive and dangerous placenta previa.Uterine artery ligation has a short operation time and a low incidence of postoperative complications,demonstrating good efficacy and safety.
invasive and dangerous placenta previacesarean sectionuterine artery ligationhysterectomyhemostatic effect
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