Predictive value of ultrasound signs of the involvement of the cervix in the adverse pregnancy outcomes of placenta accreta spectrum
10.3760/cma.j.cn131148-20210814-00558
- VernacularTitle:宫颈受累的超声征象对胎盘植入性疾病临床分级诊断及不良妊娠结局的预测价值
- Author:
Jingjing XUE
1
;
Li WANG
;
Jingjing CUI
;
Qingqing WU
;
Jingjing WANG
;
Xiaowei LIU
;
Xinlian WANG
;
Yang ZHAN
Author Information
1. 首都医科大学附属北京妇产医院/北京妇幼保健院超声科，北京 100026
- Keywords:
Ultrasonography;
Placenta accreta spectrum;
Involvement of the cervix;
Massive hemorrhage after postpartum;
Total hysterectomy;
Ultrasonic signs
- From:
Chinese Journal of Ultrasonography
2022;31(2):135-139
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the the predictive value of ultrasound signs of the involvement of the cervix in the clinical grade diagnosis of placenta accreta spectrum(PAS) with placenta previa and adverse pregnancy outcomes.Methods:A retrospective analysis was performed on PAS patients with placenta previa diagnosed during delivery or by cesarean section in Beijing Obstetrics and Gynecology Hospital Affiliated to Capital Medical University from January 2018 to March 2021. According to the signs of cervical involvement on prenatal ultrasound, the patients were divided into cervical involvement group and cervical non-involvement group. Logistic analysis was performed on clinical data between the two groups. The clinical data, hysterectomy rate, intraoperative blood loss and clinical diagnosis were compared between the two groups.Results:There were 1 455 patients with PAS diagnosed by clinical diagnosis or placental pathology, of which 170 were with placenta previa, 24 with incomplete clinical data or non-standard ultrasound images, and the remaining 146 patients were included. In the cervical involvement group, all of 6 cases had placenta percreta. Of the 140 cases in the unaffected cervical group, 89 cases (63.6%) had placental accreta, 48 cases (34.3%) had placental increta, and 3 cases (2.1%) had placenta percreta. There were no significant differences of the age and uterine operation history between the two groups. There was significant difference in the number of cesarean sections between the two groups ( P<0.05). There were significant differences in intraoperative blood loss, hysterectomy rate and placenta accreta grade diagnosis between the two groups(χ 2/ Z=4.203, 11.165, 95.248, all P<0.05). Conclusions:The ultrasonographic signs of cervical involvement have a good predictive value for the pregnancy outcome of PAS.
