Affiliation:
1. Department of Radiology, Sichuan Provincial People's Hospital University of Electronic Science and Technology of China Chengdu China
Abstract
BackgroundMRI features may be associated with adverse maternal outcome in patients with placenta accreta spectrum (PAS) disorders even with abdominal aortic balloon occlusion (AABO).PurposeThis study aimed to identify risk factors of MRI for association with adverse maternal outcome in patients with PAS disorders after AABO.Study TypeRetrospective.PopulationClinical and MRI features of 80 patients were retrospectively reviewed from October 2016 to August 2021. A total of 40 patients had adverse maternal outcomes including intrapartum/peripartum bleeding >1000 mL and/or emergency hysterectomy after AABO.SequenceHalf‐Fourier acquisition single‐shot turbo spin echo and gradient echo imaging True fast imaging with steady‐state precession (True‐FISP) at 1.5T MR scanner.AssessmentMRI features were evaluated by three radiologists and were tested for any association with adverse maternal outcome.Statistical TestsInterobserver agreement was calculated with kappa (k) statistics. Association between MRI features and adverse maternal outcomes were evaluated by univariate and multivariate analyses. A nomogram was constructed based on the logistic regression.ResultsThe interobserver agreement ranged from fair to substantial (k = 0.379–0.783). Multivariate analyses revealed that short cervical length (OR: 4.344), abnormal intraplacental vascularity (OR: 6.005), placental bulge (OR: 9.085), and myometrial interruption (OR: 9.550) were independent risk factors for adverse maternal outcomes. The combination of four risk factors together demonstrated the highest AUC of 0.851 (95% CI 0.769–0.933) with a sensitivity and specificity of 77.5% and 72.5%, respectively and then a nomogram composed of the above four risk factors was constructed to represent the probability of adverse maternal outcome.Data ConclusionThe nomogram demonstrated the association between MRI features and patient's poor outcome after undergoing AABO and C‐section delivery for PAS.Evidence Level4Technical EfficacyStage 3
Funder
Department of Science and Technology of Sichuan Province
Subject
Radiology, Nuclear Medicine and imaging
Reference39 articles.
1. FIGO consensus guidelines on placenta accreta spectrum disorders: Introduction,
2. FIGO consensus guidelines on placenta accreta spectrum disorders: Epidemiology,
3. A Lancet Commission on 70 years of women's reproductive, maternal, newborn, child, and adolescent health in China
4. Placenta accreta: challenging diagnosis and management strategies;He F;Chin J Pract Gynecol Obstet,2016
5. Interpretation of Society of Abdominal Radiology and European Society of Urogenital Radiology Joint Consensus Statement for MRI imaging of placenta accreta spectrum disorders;Wang X;Chin J Obstet Gynecol Pediatr (Electron Ed),2020
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