Abstract
Objective
The purpose of this study is to evaluate the capacity of two MRI parameters to predict massive hemorrhage in pregnancies with placenta accreta spectrum disorders.
Methods and materials:
This case-control study evaluated 174 patients who underwent MRI for placental assessment. MRI images were reviewed by two experienced radiologists blinded to all clinical data. Multivariate logistic regression was performed to analyze the risk factors for patients with massive hemorrhage. The area under the curve were used to compare the predictive ability between cervical length and cervical volume.
Results
Patients with massive hemorrhage exhibited smaller neonatal birthweight (P < 0.001), longer operation time (P < 0.001), and more blood loss (P < 0.001). The percentage of ICU admission and hysterectomy were both significantly higher than patients without massive hemorrhage. The area under the curve of cervical length and cervical volume in predicting MH were 0.812 and 0.845, respectively. And the area under the curve increased to 0.906 by the two combined parameters.
Conclusion
Shorter cervical length and smaller cervical volume are associated with massive hemorrhage during cesarean section. These methods can be utilized to better predict massive hemorrhage in placenta accreta spectrum disorders.