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OP05.05: Comparison of contrast‐enhanced ultrasound (CEUS) with colour Doppler ultrasound in the assessment of perfusion in morbidly adherent placenta
Author(s) -
Chen W.C.
Publication year - 2018
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1002/uog.19430
Subject(s) - medicine , ultrasound , contrast enhanced ultrasound , grey scale , radiology , region of interest , placenta , color doppler , perfusion , doppler effect , nuclear medicine , ultrasonography , pregnancy , fetus , genetics , physics , astronomy , biology , computer science , computer vision
Objectives: The aim of this study is to validate scoring model and secondly to develop nomogram predicting peripartum complications (ie, Caesarean hysterectomy, uterine artery embolisation and blood transfusion) in placenta previa. We previously demonstrated a scoring model predicting adverse outcome in women with placenta previa delivered in our institution from 2011 to 2013. Methods: For validation, a prediction model composed of six factors (type of previa, lacunae, uteroplacental vascularity, multiparity, history of CS and history of previa) was suggested from data of 141 singleton pregnant women with placenta previa delivered by Caesarean section (CS) from January 2014 to January 2018. Validation of this model was performed using logistic regression analysis and receiver operating characteristic (ROC) curve analysis. For the construction of nomograms, we included 254 singleton pregnant women with placenta previa delivered by Caesarean section from January 2011 to January 2018. Nomograms predicting peripartum complications were developed based on multivariable logistic regression models. Results: In validation ROC study, the AUC for the prediction of composite complication was 0.74 (0.66-0.83) with 61.5% sensitivity, 83.1% specificity, 78.7% positive predictive value and 68.0% negative predictive value at score 5. In the ROC analysis of each complication, the AUC were 0.94 (0.88-0.99) with optimal cut off of score 7 for hysterectomy, 0.89 (0.80-0.98) with optimal cut off of score 6 for uterine artery embolisation and 0.74 (0.66-0.83) with optimal cut off of score 5 for transfusion. Nomograms for the prediction of peripartum complications were constructed including only three factors in scoring model such as history of prior CS, type of placenta and uteroplacental vascularity. Conclusions: Our scoring model and nomograms for predicting peripartum complications will provide valuable information to patients with placenta previa.