Prediction of cesarean hysterectomy in placenta previa complicated with prior cesarean: a retrospective study
| Autor: | Hong-Ning Xie, Songqing Deng, Yimin Chen, Lixia Shen, Bin Liu, Jian Cai, Meifang Lin, Jianjian Cui, Jian-bo Yang, Zilian Wang, Jinxin Zhang |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
medicine.medical_specialty medicine.medical_treatment Blood Loss Surgical Placenta Previa Hysterectomy lcsh:Gynecology and obstetrics 03 medical and health sciences 0302 clinical medicine Predictive Value of Tests Pregnancy Risk Factors medicine Humans Medical history 030212 general & internal medicine Risk factor lcsh:RG1-991 reproductive and urinary physiology Retrospective Studies 030219 obstetrics & reproductive medicine Obstetrics business.industry Cesarean Section Obstetrics and Gynecology Retrospective cohort study medicine.disease Placenta previa Low-Lying Placenta ROC Curve Predictive value of tests Female business Research Article |
| Zdroj: | BMC Pregnancy and Childbirth BMC Pregnancy and Childbirth, Vol 20, Iss 1, Pp 1-6 (2020) |
| ISSN: | 1471-2393 |
| Popis: | Background The prevalence of both placenta previa and cesarean are on the rise. Multiple adverse outcomes are critically increased when placenta previa is subsequent to prior cesarean. The purpose of the present study is to develop a pre-surgical method for predicting adverse outcomes in pregnancy complicated with both placenta previa and prior cesarean. Methods Clinical data was obtained from the medical history system at the First Affiliated Hospital of Sun Yat-sen University from February 2003 to December 2016. All cases with a final diagnosis of “placenta previa/low lying placenta (ICD:O44.001-105)” and “scarred uterus complicated with pregnancy (ICD: O34.200-202)” were collected and reviewed. Hysterectomy was taken as the primary outcome; and blood loss was taken as the secondary outcome. Results Of 219 pregnant women in the final analysis, 25 received a hysterectomy following delivery, and 48 had blood loss exceeding 1000 ml. Pre-surgical risk factors for hysterectomy are ultrasonic signs of vascular lacunae, central placenta previa, and loss of normal hypoechoic retroplacental zone. A pre-surgical predictive equation referred to as “Hysterectomy Index in Placenta Previa with Prior cesarean (HIPs)” was generated and each risk factor was weighted to create an 8-point scale. This index yielded an area under the curve of 0.972 for the prediction of hysterectomy. Conclusions Application of the HIPs score may provide an effective pre-surgical prediction of cesarean hysterectomy in pregnant women complicated with both placenta previa and prior cesarean. |
| Databáze: | OpenAIRE |
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