Evidence map›Paper›PMID 29404775›Full record

SynthesisEuropean radiology2018

Endovascular interventional modalities for haemorrhage control in abnormal placental implantation deliveries: a systematic review and meta-analysis.

Yousef Shahin, Chun Lap Pang

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in European radiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
31citing papers in PubMed, 5 pooled it
19.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

31 citing papers in PubMed, 5 syntheses or guidelines pooled it, 108 citations in OpenAlex.

  1. Pooled it
  2. Prophylactic internal iliac artery balloon occlusion in the management of placenta accreta spectrum disorders: a meta-analysis.Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors at 2 institutions in 1 country.

Yousef ShahinAcademic Unit of Radiology, University of Sheffield, Glossop Road, Sheffield, S10 2JF, UK. yousef.shahin@yahoo.co.uk.ORCID http://orcid.org/0000-0001-7425-7798
Chun Lap PangPlymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, UK.
Derriford Hospital · GBSheffield Teaching Hospitals NHS Foundation Trust · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo examine the evidence regarding the effectiveness and safety of endovascular interventional modalities for haemorrhage control in abnormal placentation deliveries.

methodsMEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched from inception to July 2017. Blood loss volume was regarded as the primary endpoint. Other important results are described. Random and fixed effects models were used for the meta-analysis.

resultsOf 385 studies identified, 69 (1,811 patients, mean age 32.9 years, range 23-39 years) were included. Mean gestational age at delivery was 35.1 weeks (range 27-38 weeks). Of 1,395 patients who underwent endovascular intervention, 587 (42%) had placenta accreta, 254 (18%) placenta increta and 313 (22%) placenta percreta. Prophylactic balloon occlusion of the internal iliac arteries (PBOIIA) was performed in 470 patients (33.6%), of the abdominal aorta (PBOAA) in 460 patients (33%), of the uterine artery (PBOUA) in 181 patients (13%), and of the common iliac arteries (PBOCIA) in 21 patients (1.5%). Primary embolization of the UA was performed in 246 patients (18%), of the pelvic collateral arteries in 12 patients (0.9%), and of the anterior division of the IIA in 5 patients (0.3%). Follow-up ranged from 0.5 to 42 months. Endovascular intervention was associated with less blood loss than no endovascular intervention (p < 0.001) with the lowest blood loss volume in patients who underwent PBOAA (p < 0.001). PBOAA was associated with a lower rate of hysterectomy (p = 0.030). Endovascular intervention did not result in increases in operative time or hospital stay.

conclusionsEndovascular intervention is effective in controlling haemorrhage in abnormal placentation deliveries. PBOAA was associated with a lower rate of hysterectomy and less blood loss than other modalities. KEY POINTS: • Endovascular intervention in abnormal placentation deliveries is effective in reducing blood loss. • Endovascular intervention did not result in longer operative time or hospital stay. • Prophylactic balloon occlusion of the abdominal aorta is superior to other modalities.

Indexed as

Aorta, AbdominalBalloon OcclusionBlood Loss, SurgicalBlood TransfusionCesarean SectionDelivery, ObstetricEmbolization, TherapeuticEndovascular ProceduresFemaleGestational AgeHumansHysterectomyIliac ArteryOperative TimePlacenta AccretaPlacenta PreviaBalloon occlusionEndovascular proceduresHaemorrhagePlacenta accretaUterine artery embolization

Identifiers

PMID29404775
OpenAlexW2787302128

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.