Value of ultrasound scoring system for assessing risk of pernicious placenta previa with accreta spectrum disorders and poor pregnancy outcomes

Journal of Medical Ultrasonics
Lingling Zhu, Limei Xie

Abstract

To evaluate a system for assessing the risk of pernicious placenta previa (PPP) with placenta accreta spectrum (PAS) disorders and poor pregnancy outcomes. This prospective study focused on PPP women at ≥ 28 weeks' pregnancy. Transabdominal or transvaginal ultrasonography was used to assess PAS and poor pregnancy outcomes with a system involving uteroplacental demarcation, number and size of lacunae, bladder line, and placental basal and lacunae flow. Every item was assigned 0-2 points, and the sum yielded the final score. Diagnosis of PAS was based on surgery or pathology. One or more of postpartum hemorrhage (PPH) ≥ 1000 ml, hysterectomy, and organ invasion were regarded as a poor pregnancy outcome. Receiver operating characteristic (ROC) curves were generated. Fifty-one PPP women were included, with 70.6% having PAS and 75.0% of PAS women having a poor pregnancy outcome. The incidence of PAS diagnosis was 36.4% for those with a score < 5 points, with 0% having a poor outcome; 76.5% for those with a score ≥ 5 to < 8 points, with 61.5% having a poor outcome; and 100% for those with a score ≥ 8 points, with 100% having a poor pregnancy outcome. The system for predicting PPP with PAS and poor pregnancy outcomes was of high accur...Continue Reading

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