Evidence map›Paper›PMID 40610997›Full record

ArticleBMC pregnancy and childbirth2025

Prophylactic internal Iliac artery balloon occlusion in placenta accreta spectrum: evaluating efficacy, risks, and clinical implications.

Rui Wang, Jiayi Li, Bing Peng, Yidan Cao, Chuan Liu, Pengfei Ye, Kaiming Li, Fumin Zhao, Haibo Qu, Lingjun Liu

Abstract read
In one paragraph

Article in BMC pregnancy and childbirth, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing 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

4 citing papers in PubMed.

  1. Review
  2. Review
  3. Review
  4. Pathophysiology and Management of Placenta Accreta Spectrum.Journal of developmental biology · 2025
    Review
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

10 authors.

Rui WangDepartment of Radiology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.
Jiayi LiDepartment of Oncology, Incaier Sichuan Friendship Hospital, Chengdu, Sichuan, China.
Bing PengDepartment of Obstetrics and Gynecology, Ministry of Education, West China Second University Hospital of Sichuan University/Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Chengdu, Sichuan, China.
Yidan CaoDepartment of Pathology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.
Chuan LiuDepartment of Radiology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.
Pengfei YeDepartment of Radiology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.
Kaiming LiDepartment of Radiology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.
Fumin ZhaoDepartment of Radiology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.
Haibo QuDepartment of Radiology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.
Lingjun LiuDepartment of Radiology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China. lingjun-20046@163.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThis study aimed to assess the efficacy and risks of prophylactic internal iliac artery balloon occlusion (IIABO) in managing placenta accreta spectrum (PAS) disorders and to discuss the clinical implications of this technique.

methodsWe retrospectively analyzed 616 confirmed patients with PAS, including placenta accreta, increta, and percreta, between December 2013 and December 2022. Patients were divided into two groups based on whether or not they received prophylactic IIABO (balloon group, n = 310; no balloon group, n = 306). The primary outcomes were intraoperative bleeding volume and operation duration. Secondary outcomes included transfusion volumes, arterial injury rates, thrombosis, lower extremity ischemia, and hospitalization costs. The diagnosis of PAS was based on ultrasonography and verified by MRI when needed. Clinical management, surgical outcomes, complications, and hospitalization-related outcomes were compared between the groups using independent sample t tests, Mann‒Whitney U tests, or Fisher's exact tests, as appropriate.

resultsThe balloon group had less intraoperative bleeding and lower transfusion volumes, with a significant difference only between placenta percreta patients (P = 0.03), who also demonstrated a shorter operation duration (P = 0.02). No significant differences were observed in demographics, placenta removal, hysterectomy, or obstetric complications between the groups. The balloon group had greater rates of arterial injury, thrombosis, and lower extremity ischemia (without significant differences) and experienced greater hospitalization costs (P = 0.01). The balloon blocking time significantly increased from the placenta accreta to placenta increta subgroups and then to the placenta percreta subgroup (P = 0.03).

conclusionsProphylactic IIABO can be beneficial for reducing intraoperative bleeding and operation duration in selected PAS patients, particularly those with placenta percreta. However, the increased vascular complications and costs must be weighed carefully. Further studies should focus on optimizing patient selection and minimizing complications.

Indexed as

Balloon OcclusionIliac ArteryPlacenta AccretaAdultBlood Loss, SurgicalBlood TransfusionCesarean SectionFemaleHumansOperative TimePostpartum HemorrhagePregnancyRetrospective StudiesTreatment OutcomeCesarean deliveryHospitalization expensesInternal Iliac artery balloon occlusionIntraoperative bleedingPlacenta accreta spectrumSurgical outcomes

Identifiers

PMID40610997
PMCPMC12231693

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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.