Li Yan, Choi Hailey H, Goldstein Ruth, Poder Liina, Jha Priyanka
Department of Radiology and Biomedical Imaging, University of California, 505 Parnassus Ave, Box 0628, San Francisco, CA, 94143, USA.
Abdom Radiol (NY). 2021 Jun;46(6):2722-2728. doi: 10.1007/s00261-020-02894-9. Epub 2021 Jan 2.
To evaluate the association of placental thickness with placenta accreta spectrum disorder in placenta previa.
In this IRB-approved, retrospective study, ultrasound (US) reports were retrospectively queried for keyword previa. US performed closest to mid-gestation were included. Three measurements were performed at the thickest portion of the placenta on longitudinal transabdominal images. Operative reports and surgical pathology were used as the reference standard. Statistical analysis was performed using unpaired T-tests and receiver operating curve (ROC) analysis.
Sixty-five patients with placenta previa were included: 38 with PAS disorder and 27 without PAS disorder, clinically or pathologically. 38/38 (100%) patients of PAS group and 16/27 (59.3%) patients of non-PAS group had history of prior cesarean section. The average placental thickness was 4.3 cm (range 1.8 cm to 7.8 cm) for PAS group and 3.0 cm (range 0.6 cm to 5.3 cm) for non-PAS group (p < 0.001). Placental thickness in patients without PAS disorder and history of prior cesarean section was 3.1 (± 1.1) cm. This was statistically different from patients who had history of prior cesarean section with PAS diagnosis (4.3 cm, P<0.01). Using ROC analysis, a threshold measurement of 4.5 cm leads to sensitivity of 50% and specificity of 96%.
Our results demonstrate that among women with placenta previa, increased placental thickness at lower uterine segment correlates with placenta accreta spectrum disorder. A threshold of 4.5 cm can be useful for screening patients with placenta previa and risks factors for PAS.
评估前置胎盘中胎盘厚度与胎盘植入谱系疾病的相关性。
在这项经机构审查委员会批准的回顾性研究中，对超声（US）报告进行回顾性查询，以查找关键词“前置胎盘”。纳入最接近孕中期时进行的超声检查。在经腹纵向图像上，于胎盘最厚处进行三次测量。手术报告和手术病理用作参考标准。采用非配对t检验和受试者操作特征曲线（ROC）分析进行统计分析。
纳入65例前置胎盘患者：38例患有胎盘植入谱系疾病，27例无胎盘植入谱系疾病（临床或病理诊断）。胎盘植入谱系疾病组的38/38（100%）患者和非胎盘植入谱系疾病组的16/27（59.3%）患者有剖宫产史。胎盘植入谱系疾病组的平均胎盘厚度为4.3厘米（范围1.8厘米至7.8厘米），非胎盘植入谱系疾病组为3.0厘米（范围0.6厘米至5.3厘米）（p<0.001）。无胎盘植入谱系疾病且无剖宫产史患者的胎盘厚度为3.1（±1.1）厘米。这与有剖宫产史且诊断为胎盘植入谱系疾病的患者（4.3厘米，P<0.01）在统计学上存在差异。使用ROC分析，阈值测量为4.5厘米时，敏感性为50%，特异性为96%。
我们的结果表明，在前置胎盘的女性中，子宫下段胎盘厚度增加与胎盘植入谱系疾病相关。4.5厘米的阈值可用于筛查前置胎盘且有胎盘植入谱系疾病风险因素的患者。
