Ultrasound diagnostic value of pernicious placenta previa with placenta accreta
WANG Guan1 TANG Qiuqin2 WU Ya1 ZHANG Rui2 WANG Lvlan2▲
1.Department of Ultrasound, Women’s Hospital of Nanjing Medical University Nanjing Women and Children’s Healthcare Hospital, Jiangsu Province, Nanjing 210004, China; 2.Department of Obstetrics, Women’s Hospital of Nanjing Medical University Nanjing Women and Children’s Healthcare Hospital, Jiangsu Province, Nanjing 210004, China
Abstract：Objective To investigate the clinical value of ultrasonography in the diagnosis of pernicious placenta previa (PPP) with placenta accreta. Methods A total of 86 cases with PPP patients admitted to Nanjing Women and Children’s Healthcare Hospital from January 2020 to June 2022 were selected. According to the postpartum pathology results, they were divided into implantation group (42 cases) and control group (44 cases). The ultrasonographic characteristics, ultrasound score, and pregnancy outcome were compared between two groups; receiver operating characteristic curve was drawn to evaluate the diagnostic value of ultrasound score in PPP pregnant women with placenta accreta. Results The proportion of the thinning of myometrium≤2.0 cm, thickening of placenta＞5.0 cm, absence of postplacental space, disordered arrangement of arcuate artery of myometrium, disordered arrangement of vessels at the junction of serous layer and bladder, distension of lower uterine segment, cervical enlargement, and rich blood flow in the placenta covering of cervical canal in the implantation group were higher than those in control group (P＜0.05). Prenatal ultrasound scores in implantation group were higher than those in control group (P＜0.05). The cut-off value of ultrasound score for the diagnosing placenta of placenta accreta in pregnant women was 7.6 points, and the area under the curve was 0.877 (95%CI: 0.832-0.927, P＜0.001), the sensitivity was 85.78%, the specificity was 78.40%, and the Joaden index was 0.64. Delivery bleeding in implantation group was higher than that in control group, the incidence of hysterectomy, neonatal jaundice, neonatal asphyxia, and neonatal death were higher than those in control group (P＜0.05). Conclusion Ultrasonographic characteristics and ultrasound scores have high clinical value in prenatal diagnosis of placenta accreta in PPP pregnant women. Placenta accreta in PPP pregnant women will significantly increase the incidence of adverse pregnancy outcomes.
2023, Vol. 20 
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