Evidence map›Paper›PMID 40413552›Full record

ArticleWorld journal of emergency surgery : WJES2025

Every minute counts: a network meta-analysis comparing the effect of prophylactic endovascular procedures in abnormal placentation.

Giulia Bonavina, Gianluca Bonitta, Alberto Aiolfi, Noemi Salmeri, Massimo Candiani, Paolo Ivo Cavoretto, Luigi Bonavina, Alessandro Bulfoni, PPH working group members

Abstract readNetwork Meta-Analysis
In one paragraph

Article in World journal of emergency surgery : WJES, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
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

3 citing papers in PubMed.

  1. Article
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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

9 authors.

Giulia BonavinaDepartment of Obstetrics and Gynecology, IRCCS Multimedica, Milan, Italy. bonavinagiulia@gmail.com.
Gianluca BonittaDepartment of Obstetrics and Gynecology, IRCCS Multimedica, Milan, Italy.
Alberto AiolfiIRCCS Ospedale Galeazzi - Sant'Ambrogio, Division of General Surgery, Department of Biomedical Science for Health, University of Milan, Milan, Italy.
Noemi SalmeriDepartment of Clinical Sciences and Community Health, Università degli Studi, Milan, Italy.
Massimo CandianiDepartment of Obstetrics and Gynaecology, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy.
Paolo Ivo CavorettoDepartment of Obstetrics and Gynaecology, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy.
Luigi BonavinaIRCCS Policlinico San Donato, Division of General and Foregut Surgery, Department of Biomedical Sciences for Health, University of Milan, Milan, Italy. luigi.bonavina@unimi.it.
Alessandro BulfoniDepartment of Obstetrics and Gynecology, IRCCS Multimedica, Milan, Italy.
PPH working group members

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPreventing postpartum haemorrhage remains a high priority worldwide. We aimed to provide all available evidence comparing maternal and neonatal outcomes of different prophylactic endovascular procedures in patients with abnormal placentation.

methodsPubmed, Embase and ClinicalTrials.gov databases were searched from inception to Nov, 2024, using relevant key words. Studies comparing outcomes of women undergoing or not prophylactic endovascular procedures in planned cesarean delivery in patients with antenatally suspected or confirmed PAS, placenta previa or both were included. An arm-based random effect frequentist network meta-analysis was performed. All available maternal and neonatal outcomes were evaluated.

resultsThree randomized controlled trials and 59 observational studies were eligible reporting on 6973 women (42.9% did not undergo any endovascular procedure, 26.7% underwent aortic balloon occlusion, REBOA, 16.6%, internal iliac balloon occlusion, PBO-IIA, 5.8%, common iliac artery occlusion, PBO-CIA, placement, and 7.8% underwent uterine artery embolization, UAE). The pooled network analysis showed that all prophylactic endovascular procedures were associated with reduced perioperative blood loss, with proximal balloon occlusion (REBOA) having the strongest effect (SMD -1.80 L, 95%CI -2.38;-1.21; I

conclusionsAlthough the preponderance of observational studies suggests caution in interpreting the results of this meta-analysis, our findings suggest that prophylactic endovascular interventional procedures, particularly aortic balloon occlusion, may substantially improve clinical outcomes in women with PAS, placenta previa or both. PROSPERO REGISTRATION NUMBER: CRD4202457398.

Indexed as

Endovascular ProceduresPlacentationPostpartum HemorrhageBalloon OcclusionCesarean SectionFemaleHumansPlacenta PreviaPregnancyAbnormal placentationAortic balloon occlusionEmbolizationPlacenta accreta spectrum disordersPlacenta previaPostpartum hemorrhage

Identifiers

PMID40413552
PMCPMC12102999

What OpenQuestion holds

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Registered trials

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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.