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Placenta percreta evaluated by MRI: correlation with maternal morbidity

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Abstract

Purpose

The purpose of this study was to evaluate the capability of MRI in depicting the topography of placenta percreta (PP) and to further explore the correlation between invasion topography and maternal outcomes.

Methods

55 patients with histologically or surgically confirmed PP were included in this retrospective study. Two senior radiologists evaluated the topography of PP based on MR images: the invasion topography was depicted as S1, S2, parametrial, bladder, and cervical invasion. The correlation between invasion topography and maternal outcomes was analyzed using Chi-square statistic.

Results

MRI showed high sensitivity and specificity in delineating the invasion topography of PP (ranging from 87.5 to 100%). MRI had 100% specificity for predicting the parametrial, bladder, and cervical invasion. The rate of cesarean hysterectomy, ureteral injuries and ICU administration, and the amount of blood transfusions in PP with S2 invasion were higher than S1 invasion (P < 0.05). In addition, all patients with bladder invasion (8/8) received partial bladder resection by urologists. All the patients with S2 parametrial invasion (12/12) or cervical invasion (9/9) underwent cesarean hysterectomy.

Conclusion

MRI was capable in predicting the invasion topography of PP patients. Moreover, PP patients with S2, parametrial, bladder or cervical invasion had more severe maternal morbidity.

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Authors and Affiliations

  1. Department of Radiology, Shandong Medical Imaging Research Institute, Shandong University, 324, Jingwu Road, Jinan, 250021, Shandong, People’s Republic of China

    Xin Chen & Guangbin Wang

  2. Department of Obstetrics, Jinan Maternity and Child Care Hospital, 2 Jianguoxiaojingsan Road, Jinan, 250001, People’s Republic of China

    Ruiqin Shan

  3. Department of Radiation Oncology, Qilu Hospital of Shandong University, 107, Wenhua Xi Road, Jinan, 250012, Shandong, People’s Republic of China

    Qingxu Song

  4. Department of Ultrasound, Shandong Medical Imaging Research Institute, Shandong University, 324, Jingwu Road, Jinan, 250021, Shandong, People’s Republic of China

    Xinhong Wei & Wen Liu

Authors
  1. Xin Chen
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  2. Ruiqin Shan
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  3. Qingxu Song
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  4. Xinhong Wei
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  5. Wen Liu
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  6. Guangbin Wang
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Contributions

XC: Design of the study, data collection, and writing the manuscript. GW: Design of the study and revising the manuscript. RS: Data collection, and writing and revising the manuscript. XW: Data collection. WL: Data collection. QS: Data analysis.

Corresponding author

Correspondence to Guangbin Wang.

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Chen, X., Shan, R., Song, Q. et al. Placenta percreta evaluated by MRI: correlation with maternal morbidity. Arch Gynecol Obstet 301, 851–857 (2020). https://doi.org/10.1007/s00404-019-05420-5

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  • DOI: https://doi.org/10.1007/s00404-019-05420-5

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