Evidence map›Paper›PMID 40198092›Full record

SynthesisInternational journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics2025

A systematic review and meta-analysis of randomized controlled trials on the effects of internal iliac artery balloon occlusion in placenta previa and placenta accreta spectrum in reducing perioperative bleeding.

Rula Iskander, Manal Massalha, Chen Remer, Ido Izhaki, Raed Salim

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Rula IskanderDepartment of Obstetrics and Gynecology, Emek Medical Center, Afula, Israel.
Manal MassalhaDepartment of Obstetrics and Gynecology, Emek Medical Center, Afula, Israel.
Chen RemerDepartment of Obstetrics and Gynecology, Emek Medical Center, Afula, Israel.
Ido IzhakiDepartment of Evolutionary and Environmental Biology, University of Haifa, Haifa, Israel.
Raed SalimDepartment of Obstetrics and Gynecology, Holy Family Hospital, Nazareth, Israel.ORCID https://orcid.org/0000-0002-3603-8452

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPreoperative prophylactic balloon occlusion (PPBO) of internal iliac arteries (IIAs) in placenta previa and placenta accreta spectrum (PAS) has been widely used as a preventive adjuvant technique to reduce blood loss and to preserve fertility. Nevertheless, the efficacy of PPBO is based primarily on retrospective studies.

objectiveTo examine the effectiveness of PPBO of the IIAs in placenta previa and PAS in reducing perioperative bleeding. SEARCH STRATEGY: MEDLINE, EMBASE, Web-of-Science, Scopus, the Cochrane Library, and ClinicalTrials.gov were searched from their inception to July 2023. SELECTION CRITERIA: Randomized controlled trial (RCT) in which the use of PPBO on the IIAs was compared to non-use. DATA COLLECTION AND ANALYSIS: The primary outcome was number of packed red blood cell (RBC) units transfused. We executed meta-analysis using a random-effects model. Quality of the studies was assessed using the Cochrane Risk-of-Bias tool. The GRADE criteria were used to assess evidence certainty. MAIN

resultsOf 164 reports identified, three RCTs representing 167 women (83 and 84 in the intervention and control groups, respectively) were eligible. Mean number of RBC units transfused was 4.52 ± 1.70 and 3.70 ± 1.88 in the intervention and control groups, respectively (weighted mean difference, 1.04; 95% CI: 0.52-1.55; P = 0.001; I

conclusionsUse of PPBO of the IIAs in placenta previa and PAS was associated with increase in number of RBC units transfused.

Indexed as

Balloon OcclusionBlood Loss, SurgicalIliac ArteryPlacenta AccretaPlacenta PreviaFemaleHumansPregnancyRandomized Controlled Trials as Topicinternal iliac arteriesmeta‐analysisplacenta accreta spectrumplacenta previapreoperative prophylactic balloon occlusionrandomized controlled trial

Identifiers

PMID40198092
PMCPMC12374018

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.