ArticleArchives of gynecology and obstetrics2026
Predicting postpartum hemorrhage in placenta accreta spectrum patients with prophylactic abdominal aorta balloon occlusion: a retrospective cohort study.
Article in Archives of gynecology and obstetrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundProphylactic abdominal aortic balloon occlusion (AABO) is a hemostasis intervention for patients with placenta accreta spectrum (PAS). However, many PAS patients with prophylactic AABO still experience postpartum hemorrhage (PPH). This study aimed to investigate the risk factors for PPH in PAS patients undergoing prophylactic AABO.
methodsThis retrospective study (2018-2024) was conducted at a tertiary hospital. PAS women undergoing prophylactic AABO before cesarean section were enrolled and divided into the PPH group and the non-PPH (NPPH) group. The clinical characteristics, ultrasound and magnetic resonance imaging (MRI) findings, and delivery outcomes were compared. The LASSO regression and multivariable logistic regression were used to identify risk factors for PPH and to construct a nomogram prediction model.
resultsIn total, 126 women were included, of whom 56 experienced PPH (44.4%). Compared to those in the NPPH group, the PPH group had higher gravidity (P = 0.022) and parity (P = 0.002), fewer gestational weeks at cesarean (34.9 vs. 35.6, P = 0.026), higher ultrasound scores (11 vs. 7, P < 0.001) and MRI-based PAS grades (P < 0.001). By integrating the results of the two regression methods, we constructed the nomogram to predict PPH risk. The ROC curve of the nomogram showed moderate discriminative ability, with an AUC of 0.749 (95% CI: 0.664-0.834).
conclusionsProphylactic AABO does not completely prevent the occurrence of PPH. The nomogram intergrating gravidity, parity, ultrasound score and MRI-based PAS grades can assist clinicians in identifying high-risk PAS patients at an early stage, which is beneficial for the preoperative assessment.
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