| Popis: |
Background: The purpose of this study was to develop a model to predict cesarean hysterectomy accompanying cesarean section in patients with placenta previa. Methods: We retrospectively reviewed 926 patients diagnosed with placenta previa who had cesarean section from January 2011 to December 2021. We analyzed data by independent t-test and Pearson’s chi-squared test. Multivariate logistic regression analysis was used to develop a predictive model and identify factors predictive for cesarean hysterectomy accompanying cesarean section. Results: A total of 44 cesarean hysterectomies (4.8%) were performed in 926 patients with placenta previa. History of cesarean section (1 (odds ratio (OR) 13.57, 95% confidence interval (CI) 4.29–42.96), ≥2 (OR 83.28, 95% CI 21.98–315.55)), anterior placenta (OR 3.06, 95% CI 1.22–7.68), adherent placenta (OR 8.78, 95% CI 3.65–21.09), presence of lacuna (OR 3.74, 95% CI 1.55–9.04), and old maternal age (≥40 years (OR 4.65, 95% CI 1.60–13.49)) were factors selected to develop a model to predict cesarean hysterectomy. Based on this model, an equation was developed and tested for performance. This model using five factors yielded an area under the curve of 0.951 (95% CI 0.921–0.981) to predict the probability of cesarean hysterectomy accompanying cesarean section. Conclusions: Application of this predictive model may provide an effective prediction of cesarean hysterectomy in patients with placenta previa. Adequate pre-operative preparation and intraoperative strategies can be indicated based on this model. |
