Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Department of Obstetrics and Gynecology, First People's Hospital of Chenzhou, Chenzhou, China.
Int J Gynaecol Obstet. 2017 Dec;139(3):336-341. doi: 10.1002/ijgo.12311. Epub 2017 Sep 27.
To assess a novel three-dimensional (3D) magnetic resonance imaging (MRI) model for determining position of uterine incision during cesarean delivery among patients with placenta previa.
A prospective study was conducted among women with singleton pregnancies complicated by placenta previa who delivered by cesarean at a hospital in China between January 1, 2014, and January 1, 2016. Patients chose whether to undergo 3D MRI modeling to guide uterine incision (study group) or the standard intervention (control group). Medical records were reviewed to collect data on maternal, neonatal, and operative characteristics.
Among 134 women enrolled, 45 were in the study group and 89 in the control group. When compared with the control group, patients in the study group experienced less intraoperative blood loss (678.65 ± 649.54 vs 933.96 ± 695.25 mL; P=0.042) and shorter operative times (65.13 ± 27.38 vs 86.88 ± 54.43 minutes; P=0.013). Fewer patients in the study group received transfusions (11 [24%] vs 38 [43%]; P=0.038). No between-group differences were found for hysterectomy rate, hospitalization days and cost, or neonatal outcomes.
Uterine incision guided by a 3D MRI model could improve maternal outcomes during cesarean delivery, including reductions in intraoperative blood loss, transfusion frequency, and operative time.
评估一种新的三维（3D）磁共振成像（MRI）模型，用于确定前置胎盘患者剖宫产时子宫切口的位置。
一项前瞻性研究在中国的一家医院进行，研究对象为 2014 年 1 月 1 日至 2016 年 1 月 1 日期间单胎妊娠合并前置胎盘的剖宫产产妇。患者选择是否进行 3D MRI 建模以指导子宫切口（研究组）或标准干预（对照组）。回顾病历以收集产妇、新生儿和手术特征的数据。
在纳入的 134 名女性中，45 名在研究组，89 名在对照组。与对照组相比，研究组术中出血量较少（678.65±649.54 比 933.96±695.25 毫升；P=0.042），手术时间更短（65.13±27.38 比 86.88±54.43 分钟；P=0.013）。研究组接受输血的患者较少（11 [24%] 比 38 [43%]；P=0.038）。两组间子宫切除术率、住院天数和费用或新生儿结局无差异。
3D MRI 模型指导的子宫切口可改善剖宫产术中的产妇结局，包括减少术中出血量、输血频率和手术时间。
