The Amount of intrapartum hemorrhage of different hemostasis methods after Placenta Accreta Spectrum

OBJECTIVE: To investigate the effect of different hemostasis methods on the amount of intrapartum hemorrhage with placenta accreta spectrum (placenta accreta, increta, and percreta). METHODS: A population-based record linkage study of women who diagnosed placenta accreta spectrum in West China Second University Hospital, Sichuan University and Chengdu Women and Children Central Hospital from January 2020 to December 2020. Data were obtained from hospital records. According to the different methods of hemostasis, they were divided into without any measure group, transcatheter arterial embolization group, balloon tamponade group, drug group and multiple combined methods group. And the differences in the amount of intrapartum hemorrhage under different hemostasis methods were compared. RESULTS: A total of 735 PAS patients were included in this study. The results showed that drug group intrapartum hemorrhage was lower than without any measure group (400 [300,600] ml and 565 [485,600] ml; P<0.001). And it is same in multiple combined methods (400 [320,600] ml and 565 [485,600] ml; P<0.001). There was no difference between transcatheter arterial embolization group and without any measure group (400 [300,600] ml and 590 [508,600] ml; P=0.137). And balloon tamponade group intrapartum hemorrhage was higher than without any measure group (400 [300,600] ml and 765 [650,885] ml; P=0.001). CONCLUSION: Drug and multiple combined methods can effectively control the amount of intrapartum hemorrhage. Transcatheter arterial embolization can’t effectively control the amount of intrapartum hemorrhage. Balloon tamponade could increase the amount of intrapartum hemorrhage. And when the amount of intrapartum hemorrhage reached 600 ml, no method could control bleeding.