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Anesthetic management of cesarean section in cases of placenta accreta, with versus without abdominal aortic balloon occlusion: study protocol for a randomized controlled trial.
- Source :
- Trials; 5/26/2017, Vol. 18, p1-7, 7p, 2 Diagrams
- Publication Year :
- 2017
-
Abstract
- <bold>Background: </bold>Placenta accreta (PA), a severe complication during delivery, is closely linked with massive hemorrhage which could endanger the lives of both mother and baby. Moreover, the incidence of PA has increased dramatically with the increasing rate of cesarean deliveries in the past few decades. Therefore, studies evaluating the effects of different perioperative managements based on different modalities in the treatment of PA are necessary. Among the numerous treatment measures, prophylactic abdominal aortic balloon occlusion (AABO) in combination with cesarean section for PA seems to be more advantageous than others. However, up to now, all studies on AABO were almost retrospective. Current evidence is insufficient to recommend for or against routinely using the AABO technology for control intraoperative hemorrhage in patients with PA. Thus, we hope to carry out a prospective, randomized controlled trial (RCT) study to confirm the effectiveness of the AABO technology in patients with PA.<bold>Methods/design: </bold>This trial is an investigator-initiated, prospective RCT that will test the superiority of AABO in combination with cesarean section compared to the traditional hysterectomy following cesarean section for parturients with PA. A total of 170 parturients with PA undergoing cesarean section will be randomized to receive either AABO in combination with cesarean section or the traditional hysterectomy following cesarean section. The primary outcome is estimated blood loss. The most important secondary outcome is the occurrence of cesarean hysterectomy during delivery; others include blood transfusion volume, operating time, neonate's Apgar scores (collected at 1, 5 and 10 min), length of stay in intensive care unit, total hospital stay, and balloon occlusion-relative data.<bold>Discussion: </bold>This prospective trial will test the superiority of AABO in combination with cesarean section compared to the traditional hysterectomy following cesarean section for parturients with PA. It may provide strong evidence about the benefits and risks of AABO in combination with cesarean section for parturients with PA.<bold>Trial Registration: </bold>Chinese Clinical Trial Registry, ChiCTR-INR-16008842 . Registered on 14 July 2016. [ABSTRACT FROM AUTHOR]
- Subjects :
- PLACENTA diseases
ARTERIAL occlusions
ANESTHESIA
ABDOMINAL aorta
RANDOMIZED controlled trials
THERAPEUTICS
DISEASES
HEMORRHAGE diagnosis
HEMORRHAGE prevention
ANESTHESIA in obstetrics
APGAR score
BLOOD circulation
BLOOD transfusion
CESAREAN section
COMPARATIVE studies
EXPERIMENTAL design
HEMORRHAGE
LENGTH of stay in hospitals
HYSTERECTOMY
LABOR complications (Obstetrics)
LONGITUDINAL method
RESEARCH methodology
MEDICAL cooperation
RESEARCH protocols
PUERPERAL disorders
RESEARCH
TIME
EVALUATION research
TREATMENT effectiveness
SURGICAL blood loss
Subjects
Details
- Language :
- English
- ISSN :
- 17456215
- Volume :
- 18
- Database :
- Complementary Index
- Journal :
- Trials
- Publication Type :
- Academic Journal
- Accession number :
- 123448391
- Full Text :
- https://doi.org/10.1186/s13063-017-1977-5