Skip to content
DraconiticResearch
Search Sources API
201,683 studies31 sourcesUpdated 27 min ago
Peer-reviewedCC BYArchives of Gynecology and Obstetrics

Predicting postpartum hemorrhage in placenta accreta spectrum patients with prophylactic abdominal aorta balloon occlusion: a retrospective cohort study

  • Ying Zha1
  • Yun Zhao1
  • Min Peng1
  • Huan Zhang1
  • Tingting Jiang1
  • Sheng Zhao2
  • Wenzhong Yang3
  • Yin Xie1
  • E Liao1
  • Hui Xie3
  • Lei Zhao1
  • Wei Ren1
8 more authors
  • Na Zhang1
  • Xiaoying Wei1
  • Jing Bao1
  • Hui Du1
  • Yaping Hu1
  • Wanjiang Zeng4
  • Yuanming Feng2
  • Guoqiang Sun1
4 affiliations
  1. 1Department of Obstetrics, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology
  2. 2Department of Ultrasound, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology
  3. 3Department of Medical Imaging, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology
  4. 4Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology
Read full textDOICite

Abstract

Background Prophylactic 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. Methods This 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. Results In 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). Conclusions Prophylactic 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.

Related

  1. Efficacy of prophylactic tranexamic acid in preventing postpartum hemorrhage following repeat cesarean sections: a retrospective matched-cohort study
    Xiaodan Di, Xiaojun Li, Zheng Zheng +3
    Frontiers in drug safety and regulationPeer-reviewedCC BYFull textObstetrics, gynaecology & paediatricsEurope PMCPMC
  2. Predicting postpartum diastasis recti abdominis using early-pregnancy abdominal wall ultrasound radiomics
    Bei Li, Zhengfang Xu, Xiaoxue Zhao +3
    Frontiers in medicinePeer-reviewedCC BYFull textGeneral medicineEurope PMC
  3. Vacuum‐assisted hemorrhage control device versus uterine balloon tamponade for refractory atonic postpartum hemorrhage in a protocol‐driven care pathway—A retrospective cohort study
    Kelvin Z. X. Lee, Calista L. S. Por, Tak Yein Lim +11
    Acta Obstetricia et Gynecologica ScandinavicaPeer-reviewedCC BY-NC-ND 4.0Full text2 citedObstetrics, gynaecology & paediatricsPMCDOAJ
  4. Dynamic fibrinogen decline rate outperforms static admission values in predicting hematoma expansion in APL-related intracranial hemorrhage: a retrospective cohort study.
    Wentao Lai, Jing Hu
    Frontiers in medicinePeer-reviewedCC BYFull textNeurologyEurope PMC
  5. Head-to-head comparison of glucose-to-albumin ratio against five albumin-derived indices for predicting 28-day ICU mortality in critically ill patients with spontaneous intracerebral hemorrhage: a multicenter retrospective study.
    Fangbin Hao, Luokai Huangfu, Wenxuan Li +8
    Frontiers in nutritionPeer-reviewedCC BYFull textNeurologyEurope PMC

Cite

BibTeXRIS
BibTeX
@article{zha2026predicting,
  title = {{Predicting postpartum hemorrhage in placenta accreta spectrum patients with prophylactic abdominal aorta balloon occlusion: a retrospective cohort study}},
  author = {Ying Zha and Yun Zhao and Min Peng and Huan Zhang and Tingting Jiang and Sheng Zhao and Wenzhong Yang and Yin Xie and E Liao and Hui Xie and Lei Zhao and Wei Ren and Na Zhang and Xiaoying Wei and Jing Bao and Hui Du and Yaping Hu and Wanjiang Zeng and Yuanming Feng and Guoqiang Sun},
  journal = {Archives of Gynecology and Obstetrics},
  year = {2026},
  month = jun,
  doi = {10.1007/s00404-026-08456-6},
  url = {https://doi.org/10.1007/s00404-026-08456-6},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Predicting postpartum hemorrhage in placenta accreta spectrum patients with prophylactic abdominal aorta balloon occlusion: a retrospective cohort study
AU  - Ying Zha
AU  - Yun Zhao
AU  - Min Peng
AU  - Huan Zhang
AU  - Tingting Jiang
AU  - Sheng Zhao
AU  - Wenzhong Yang
AU  - Yin Xie
AU  - E Liao
AU  - Hui Xie
AU  - Lei Zhao
AU  - Wei Ren
AU  - Na Zhang
AU  - Xiaoying Wei
AU  - Jing Bao
AU  - Hui Du
AU  - Yaping Hu
AU  - Wanjiang Zeng
AU  - Yuanming Feng
AU  - Guoqiang Sun
PY  - 2026
DA  - 2026/06/01
JO  - Archives of Gynecology and Obstetrics
DO  - 10.1007/s00404-026-08456-6
UR  - https://doi.org/10.1007/s00404-026-08456-6
AB  - Background Prophylactic 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. Methods This 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. Results In 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). Conclusions Prophylactic 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.
SN  - 1432-0711
ER  -