Scoring system for the prediction of the severity of placenta accrete spectrum in women with placenta previa: a prospective observational study
| Autor: | Li Luo, Ping Yan, Qiu-Lei Sun, Zhengqiong Chen, Xiaohua Wu, De-Mei Ying, Ying Yang |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
medicine.medical_specialty China Scoring system Placenta Population Placenta Previa Placenta Accreta Ultrasonography Prenatal 03 medical and health sciences 0302 clinical medicine Vascularity Predictive Value of Tests Pregnancy Risk Factors Medicine Humans In patient Prospective Studies education education.field_of_study 030219 obstetrics & reproductive medicine business.industry Obstetrics Obstetrics and Gynecology General Medicine medicine.disease Placenta previa medicine.anatomical_structure 030220 oncology & carcinogenesis Observational study Myometrial thickness Female medicine.symptom business |
| Zdroj: | Archives of gynecology and obstetrics. 300(3) |
| ISSN: | 1432-0711 |
| Popis: | The clinical outcomes are significantly different in accreta, increta, and percreta. There is currently no scoring system that can preoperatively distinguish its severity in an at-risk population. The aim of this study is to establish a scoring system for the prediction of the severity of placenta accrete spectrum (PAS) in women with placenta previa. A prospective observational study was conducted in patients with placenta previa who delivered at a Chinese tertiary care center between June 12, 2016 and June 30, 2018. Optimal scaling regression was performed to determine the parameters which really contribute to the prediction of PAS, and calculate percentage of contribution. Among 392 cases with placenta previa, 79, 53, and 28 had been surgically and/or histologically confirmed as accreta, increta, or percreta, respectively. Seven parameters were scheduled for the estimated scores for PAS, and five of them were finally entered into the predictive model. Their percentage of contribution was as follows: placental lacunas (19%), vascularity at the uterus–bladder interface (17.5%), myometrial thickness and hypoechoic retroplacental zone (25.6%), bladder line (22.6%), and previous caesarean sections (15.3%). The thresholds of scores for the prediction of accreta, increta, and percreta yielded 2.25–6.2, 6.2–8.95, and ≧ 8.95, respectively, with the positive and negative predictive value, and false positive rates of the scoring system were 96.68%, 95.44%, and 3.32%, respectively. The scoring system can predict the severity of PAS in women with placenta previa. This will help identify the actual high-risk patients and improve their treatment. |
| Databáze: | OpenAIRE |
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