Tsz-Kin Lo

This study compared maternal and foetal outcomes of managing placenta accreta spectrum (PAS) disease with and without prophylactic internal iliac balloon occlusion (IIABO) at a tertiary hospital between 2002 and 2021. This retrospective cohort study included patients with confirmed PAS disorder, comparing maternal and foetal outcomes between those who underwent IIABO before caesarean delivery and those who did not, both receiving standardised multidisciplinary care. Primary outcomes included perioperative haemoglobin drop. Secondary outcomes included estimated blood loss, transfusion rate, operative duration, ICU stay, hysterectomy rates, and newborns' Apgar scores. Thirty-one antenatally diagnosed PAS patients were analysed (IIABO n = 21, non-IIABO n = 10). Over 90% had prior caesarean deliveries. IIABO is associated with lower intraoperative haemoglobin drop (p < .001) and higher postoperative haemoglobin (p = 0.047). The linear regression model demonstrated that IIABO and classical caesarean significantly reduced intraoperative blood loss (p = 0.019). No differences were seen in operative time, ICU stay, hysterectomy rates, or newborn Apgar scores. No IIABO-related complications were reported. Prophylactic IIABO during caesarean delivery for PAS is associated with less haemoglobin drop and higher postoperative haemoglobin. IIABO under local anaesthesia was feasible, possibly reducing risks tied to extended general anaesthesia. Larger studies are recommended to support the role of IIABO in PAS disorders.

The present study supports screening of pregnancies with cesarean scar for PASD in routine clinical settings. Managing false‐positive cases as PASD is justified.

(2019). Decision outcomes of women choosing extended non-invasive prenatal testing. Journal of Obstetrics and Gynaecology. Ahead of Print.

In this first Asian study, the decision outcomes (decision conflict, decision regret, and anxiety) of 262 pregnant women offered noninvasive prenatal test (NIPT) for high-risk Down screening results were assessed. Decision conflict was experienced by 3.5% and level of decisional regret low (mean score 15.7, 95%CI 13.2–18.3). All 13 cases of decisional regret were NIPT acceptors. Elevated anxiety was experienced by 55.9% at the time of decision making about NIPT and persistent in 30.3%. Insufficient knowledge about NIPT was associated with elevated anxiety at decision making (p = .011) and with decisional regret (p = .016). Decisional regret was associated with prolonged anxiety (p = .010).