Mohammadi Afsaneh, Bouzari Zinatossadat, Hajian-Tilaki Karimollah, Nabahati Mehrdad, Mehraeen Rahele
Department of Radiology, Babol University of Medical Sciences, Babol, Iran.
Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
Caspian J Intern Med. 2022 Winter;13(1):10-15. doi: 10.22088/cjim.13.1.10.
Placenta accreta is one of the known causes of maternal mortality and morbidity. If diagnosed before delivery, appropriate actions can be taken. The aim of this study was to investigate the role of scaling combination of risk factors in predicting placenta accreta spectrum (PAS).
In this cross-sectional study, 120 pregnant women with two criteria and more of placenta previa in their ultrasound, underwent MRI. Clinical scores (history of surgery, cesarean section, previa, etc.) and paraclinical scores (ultrasound and MRI) were recorded and combined. In cases of hysterectomy, pathological examination was performed. The results were compared and analyzed using SPSS Version 22. The significance level was less than 0.05.
Of the120 studied patients, 90 (75%) women were diagnosed with placenta previa in which, 32(36%) patients had placenta accreta and 12 patients had placenta accreta without placenta previa. The mean ultrasound score in women without and with placenta accreta were 0.05±0.32 and 2.43±1.83 (p<0.001). The mean MRI score in women without and with placenta accreta were 0.05±0.27 and 2.07±2.02, respectively. The cut-off point, sensitivity and specificity were 0.50, 100% and 93.4%, respectively. The mean clinical score without and with placenta accreta were 1.97±1.32 and 4.89±3.21, respectively. The cut-off point, sensitivity and specificity were 2.50, 70% and 80%, respectively. The cut-off point of combination score, sensitivity and specificity were 3.50, 89%, 83%.
The results of the present study showed that the most specific test to confirm the definitive diagnosis of placenta accreta is paraclinical score, alone.
胎盘植入是已知的孕产妇死亡和发病原因之一。如果在分娩前诊断出来，就可以采取适当的措施。本研究的目的是调查风险因素综合评分在预测胎盘植入谱系（PAS）中的作用。
在这项横断面研究中，120名超声检查符合两项及以上前置胎盘标准的孕妇接受了磁共振成像（MRI）检查。记录并综合临床评分（手术史、剖宫产史、前置胎盘等）和辅助检查评分（超声和MRI）。对于接受子宫切除术的病例，进行了病理检查。使用SPSS 22版对结果进行比较和分析。显著性水平小于0.05。
在120名研究患者中，90名（75%）女性被诊断为前置胎盘，其中32名（36%）患者有胎盘植入，12名患者有胎盘植入但无前置胎盘。无胎盘植入和有胎盘植入女性的超声平均评分分别为0.05±0.32和2.43±1.83（p<0.001）。无胎盘植入和有胎盘植入女性的MRI平均评分分别为0.05±0.27和2.07±2.02。截断点、敏感性和特异性分别为0.50、100%和93.4%。无胎盘植入和有胎盘植入的临床平均评分分别为1.97±1.32和4.89±3.21。截断点、敏感性和特异性分别为2.50、70%和80%。综合评分的截断点、敏感性和特异性分别为3.50、89%、83%。
本研究结果表明，单独用于确诊胎盘植入的最具特异性的检查是辅助检查评分。
