Risk Scoring System with MRI for Intraoperative Massive Hemorrhage in Placenta Previa and Accreta in Fayoum university hospital | ||
| Evidence Based Women's Health Journal | ||
| Articles in Press, Accepted Manuscript, Available Online from 22 April 2024 | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ebwhj.2024.284273.1321 | ||
| Author | ||
| hagar moustafa mohamed* | ||
| obstetrics and gynecology alfayoum university hospital,fayoum faculty of medicine | ||
| Abstract | ||
| Abstract: Objective: To predict massive intrapartum blood loss among women with placenta previa/accreta. Methods: This prospective cohort study was conducted at the department of obstetrics and gynecology at Fayoum University from September 2021 to February 2023. This study recruited women diagnosed with placenta previa/accreta spectrum according to prespecified inclusion and exclusion criteria. The diagnosis was confirmed by MRI. A scoring system was developed from the clinical and MRI findings to predict massive blood loss. Results: The mean age of the study population was 30.52 ± 5.76 years. The amount of blood loss was 2790 ± 1331.5 cc and more than half patients (64%) had lost ≥2000 cc of blood. Multivariable Logistic regression analysis reveals that the only factors associated with amount of blood loss were pregnancy complications and evidence of focal bulge by MRI. Based on the results of ROC curve analysis, risk scoring system obtained from the multivariable logistic regression model can significantly predict the intraoperative massive hemorrhage (≥2000 blood loss) as (AUC: 0.900, P<0.001). The suggested cut off (>19 points) has sensitivity of 87.5%, specificity of 83.3%, PPV of 90.3% and NPV of 78.9%. Conclusion: MRI is very important in the diagnosis of placenta previa/accreta. The developing of a scoring system for the prediction of intrapartum blood loss is paramount. | ||
| Keywords | ||
| Placenta previa; Placenta accreta; Blood loss; Scoring system; Prediction | ||
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