A combined ultrasound and clinical scoring model for the prediction of peripartum complications in pregnancies complicated by placenta previa.

Abstract

OBJECTIVES:

To generate a combined ultrasound and clinical model predictive for peripartum complications in pregnancies complicated by placenta previa.

STUDY DESIGN:

This study included 110 singleton pregnant women with placenta previa delivered by cesarean section (CS) from July 2011 to November 2013. We prospectively collected ultrasound and clinical data before CS and observed the occurrence of blood transfusion, uterine artery embolization and cesarean hysterectomy. We formulated a scoring model including type of previa (0: partials, 2: totalis), lacunae (0: none, 1: 1-3, 2: 4-6, 3: whole), uteroplacental hypervascularity (0: normal, 1: moderate, 2: severe), multiparity (0: no, 1: yes), history of CS (0: none, 1: once, 2: ≥ twice) and history of placenta previa (0: no, 1: yes) to predict the risk of peripartum complications.

RESULTS:

In our study population, the risk of perioperative transfusion, uterine artery embolization, and cesarean hysterectomy were 26.4, 1.8 and 6.4%, respectively. The type of previa, lacunae, uteroplacental hypervascularity, parity, history of CS, and history of placenta previa were associated with complications in univariable analysis. However, no factor was independently predictive for any complication in exact logistic regression analysis. Using the scoring model, we found that total score significantly correlated with perioperative transfusion, cesarean hysterectomy and composite complication (p<0.0001, Cochrane Armitage test). Notably, all patients with total score ≥7 needed cesarean hysterectomy. When total score was ≥6, three fourths of patients needed blood transfusion.

CONCLUSIONS:

This combined scoring model may provide useful information for prediction of peripartum complications in women with placenta previa.

• Authors: So-Yeon Yoon, Ji Yeon You, Suk-Joo Choi, Soo-Young Oh, Jong-Hwa Kim, Cheong-Rae Roh
• Journal: European journal of obstetrics, gynecology, and reproductive biology (Eur J Obstet Gynecol Reprod Biol) Vol. 180 Pg. 111-5 (Sep 2014) ISSN: 1872-7654 [Electronic] Ireland
• PMID: 25079491 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Topics

• Adult
• Blood Transfusion (statistics & numerical data)
• Cesarean Section
• Decision Support Techniques
• Female
• Humans
• Hysterectomy (statistics & numerical data)
• Infant, Newborn
• Male
• Peripartum Period
• Placenta Previa (diagnostic imaging)
• Postpartum Hemorrhage (therapy)
• Pregnancy
• Prospective Studies
• Risk Assessment
• Ultrasonography
• Uterine Artery Embolization (statistics & numerical data)