Clinical utility of sonography in the diagnosis and treatment of placental abruption
| Autor: | Leslie Purnell, Chris Glantz |
|---|---|
| Rok vydání: | 2002 |
| Předmět: |
Pregnancy
medicine.medical_specialty Hematoma Neonatal intensive care unit Radiological and Ultrasound Technology Placental abruption business.industry Obstetrics Gestational age medicine.disease Sensitivity and Specificity Ultrasonography Prenatal Low birth weight Predictive Value of Tests Predictive value of tests Positive predicative value Medicine Humans Radiology Nuclear Medicine and imaging Vaginal bleeding Female medicine.symptom business Abruptio Placentae |
| Zdroj: | Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine. 21(8) |
| ISSN: | 0278-4297 |
| Popis: | Objective. To determine the sensitivity and specificity of sonography for detection of placental abruption and whether sonographic results correlate with management or outcome. Methods. We identified 149 consecutive patients who underwent sonography at 24 weeks' gestational age or later for ruling out abruption or vaginal bleeding. Obstetric and neonatal data were obtained from the hospital perinatal database. Sonographic results, pathologic reports, and hospital charts were reviewed. Sonographic sensitivity, specificity, and positive and negative predictive values were calculated, and regression was used to determine independence of associations. Results. Of the 149 patients, 17 (11 %) had sonographic evidence of abruption, and 32 (21%) had evidence of abruption at delivery. As the scan-to-delivery interval decreased, the positive predictive value increased and the negative predictive value decreased. Of 55 patients who gave birth within 14 days of sonography, 8 (15%) had scans consistent with abruption, and 29 (53%) had abruption at delivery; the sensitivity, specificity, and positive and negative predictive values of sonography were 24%, 96%, 88%, and 53%, respectively. Positive sonographic findings were univariately associated with 2- to 3-fold greater subsequent tocolysis, betamethasone use, duration of hospitalization, follow-up sonograms, preterm delivery, low birth weight, and neonatal intensive care unit admission. All but low birth weight and neonatal intensive care unit admission remained independently significant after adjustment for gestational age (P |
| Databáze: | OpenAIRE |
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