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Value of ultrasound scoring system for assessing risk of pernicious placenta previa with accreta spectrum disorders and poor pregnancy outcomes

  • Original Article–Obstetrics & Gynecology
  • Published:
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Abstract

Purpose

To evaluate a system for assessing the risk of pernicious placenta previa (PPP) with placenta accreta spectrum (PAS) disorders and poor pregnancy outcomes.

Methods

This prospective study focused on PPP women at ≥ 28 weeks’ pregnancy. Transabdominal or transvaginal ultrasonography was used to assess PAS and poor pregnancy outcomes with a system involving uteroplacental demarcation, number and size of lacunae, bladder line, and placental basal and lacunae flow. Every item was assigned 0–2 points, and the sum yielded the final score. Diagnosis of PAS was based on surgery or pathology. One or more of postpartum hemorrhage (PPH) ≥ 1000 ml, hysterectomy, and organ invasion were regarded as a poor pregnancy outcome. Receiver operating characteristic (ROC) curves were generated.

Results

Fifty-one PPP women were included, with 70.6% having PAS and 75.0% of PAS women having a poor pregnancy outcome. The incidence of PAS diagnosis was 36.4% for those with a score < 5 points, with 0% having a poor outcome; 76.5% for those with a score ≥ 5 to < 8 points, with 61.5% having a poor outcome; and 100% for those with a score ≥ 8 points, with 100% having a poor pregnancy outcome.

Conclusion

The system for predicting PPP with PAS and poor pregnancy outcomes was of high accuracy.

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Acknowledgements

We gratefully acknowledge the help received from Dr. Taotao Song and Dr. Hui Sun as they provided valuable clinical data in preparing this original article.

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Author notes

  1. Limei Xie

    Present address: Ultrasound Department, Roicare Hospital and Clinics, No. 136 Dongbeida Road, Shenyang, 110044, Liaoning, China

Authors and Affiliations

  1. Ultrasound Department, Sheng Jing Hospital of China Medical University, No. 36 Sanhao Street, Shenyang, 110004, Liaoning, China

    Lingling Zhu & Limei Xie

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  1. Lingling Zhu
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Correspondence to Limei Xie.

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Ethical approval

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions.

Conflict of interest

Lingling Zhu and Limei Xie declare that they have no conflicts of interest.

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Informed consent was obtained from all patients for being included in the study.

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Zhu, L., Xie, L. Value of ultrasound scoring system for assessing risk of pernicious placenta previa with accreta spectrum disorders and poor pregnancy outcomes. J Med Ultrasonics 46, 481–487 (2019). https://doi.org/10.1007/s10396-019-00965-z

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  • DOI: https://doi.org/10.1007/s10396-019-00965-z

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