Prediction of placenta accreta spectrum by a scoring system based on maternal characteristics combined with ultrasonographic features

Objective: In order to create a comprehensive scoring system based on maternal characteristics and ultrasonographic features for predicting placenta accreta spectrum (PAS). Materials and methods: This was a retrospective review of pregnant women who underwent routine ultrasound examination in the th...

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Autores principales:	Yisu Gao, Xuejiao Gao, Jing Cai, Fang Han, Guixiang Xu, Xuan Zhang, Ting Zhang, Lili Yu
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Placenta accreta spectrum Maternal characteristics Two-dimensional ultrasound Comprehensive scoring system Prediction Gynecology and obstetrics RG1-991
Acceso en línea:	https://doaj.org/article/e130a0f760cb4eaab0d237f58d8526e7
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spelling	oai:doaj.org-article:e130a0f760cb4eaab0d237f58d8526e72021-11-18T04:44:41ZPrediction of placenta accreta spectrum by a scoring system based on maternal characteristics combined with ultrasonographic features1028-455910.1016/j.tjog.2021.09.011https://doaj.org/article/e130a0f760cb4eaab0d237f58d8526e72021-11-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S1028455921002515https://doaj.org/toc/1028-4559Objective: In order to create a comprehensive scoring system based on maternal characteristics and ultrasonographic features for predicting placenta accreta spectrum (PAS). Materials and methods: This was a retrospective review of pregnant women who underwent routine ultrasound examination in the third trimester of pregnancy from January 2014 to November 2018 were used as a training set to establish the scoring system for PAS prediction while those who underwent examination from January 2019 to December 2019 served as a validation set.. Maternal characteristics including maternal age, parity, previous vaginal deliveries, previous curettage, previous cesarean section (CS), history of hypertension and diabetes mellitus, prenatal body mass index (BMI) were recorded. Ultrasonographic features including abnormal placental lacunae, subplacental hypervascularity, myometrial thinning, placental bulge, bladder wall interruption, location of placenta, placenta previa (yes or not) were recorded. Multivariate analysis was applied to analyze independent risk factors and assess the predictive power of selected parameters predicting PAS. Receiver operating characteristics (ROC) curve was used to evaluate the diagnosis power. Results: Parity, previous curettage and CS were independent risk factors. The best comprehensive scoring system was established as follow: the number of abnormal lacunae ≥3, 2 points; lacuna maximum dimension ≥2 cm, 5 points; subplacental hypervascularity (rich), 1 point; subplacental hypervascularity (extremely rich and disordered), 3 points; bladder wall interruption, 9 points; placental bulge, 9 points; placenta previa, 8 points; anterior placenta, 1 point; previous CS ≥ 1, 1 point; parity ≥ 4, 3 point; previous abortions ≥ 2, 1 point. The area under the ROC curve of the scoring system diagnosing PAS was 0.925. Sensitivity and specificity were 83.3% and 85.7%, respectively. Cross-validation for our model showed that sensitivity, specificity, positive predictive value and negative predictive value of the model in diagnosis of PAS were 82.6%, 81.8%, 82.6% and 81.8%, respectively. Diagnosis of 37 cases were consistent with the “gold standard”, and the coincidence rate was 82.2% (37/45). Conclusion: The comprehensive scoring system established in this study can effectively diagnose PAS.Yisu GaoXuejiao GaoJing CaiFang HanGuixiang XuXuan ZhangTing ZhangLili YuElsevierarticlePlacenta accreta spectrumMaternal characteristicsTwo-dimensional ultrasoundComprehensive scoring systemPredictionGynecology and obstetricsRG1-991ENTaiwanese Journal of Obstetrics & Gynecology, Vol 60, Iss 6, Pp 1011-1017 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Placenta accreta spectrum Maternal characteristics Two-dimensional ultrasound Comprehensive scoring system Prediction Gynecology and obstetrics RG1-991
spellingShingle	Placenta accreta spectrum Maternal characteristics Two-dimensional ultrasound Comprehensive scoring system Prediction Gynecology and obstetrics RG1-991 Yisu Gao Xuejiao Gao Jing Cai Fang Han Guixiang Xu Xuan Zhang Ting Zhang Lili Yu Prediction of placenta accreta spectrum by a scoring system based on maternal characteristics combined with ultrasonographic features
description	Objective: In order to create a comprehensive scoring system based on maternal characteristics and ultrasonographic features for predicting placenta accreta spectrum (PAS). Materials and methods: This was a retrospective review of pregnant women who underwent routine ultrasound examination in the third trimester of pregnancy from January 2014 to November 2018 were used as a training set to establish the scoring system for PAS prediction while those who underwent examination from January 2019 to December 2019 served as a validation set.. Maternal characteristics including maternal age, parity, previous vaginal deliveries, previous curettage, previous cesarean section (CS), history of hypertension and diabetes mellitus, prenatal body mass index (BMI) were recorded. Ultrasonographic features including abnormal placental lacunae, subplacental hypervascularity, myometrial thinning, placental bulge, bladder wall interruption, location of placenta, placenta previa (yes or not) were recorded. Multivariate analysis was applied to analyze independent risk factors and assess the predictive power of selected parameters predicting PAS. Receiver operating characteristics (ROC) curve was used to evaluate the diagnosis power. Results: Parity, previous curettage and CS were independent risk factors. The best comprehensive scoring system was established as follow: the number of abnormal lacunae ≥3, 2 points; lacuna maximum dimension ≥2 cm, 5 points; subplacental hypervascularity (rich), 1 point; subplacental hypervascularity (extremely rich and disordered), 3 points; bladder wall interruption, 9 points; placental bulge, 9 points; placenta previa, 8 points; anterior placenta, 1 point; previous CS ≥ 1, 1 point; parity ≥ 4, 3 point; previous abortions ≥ 2, 1 point. The area under the ROC curve of the scoring system diagnosing PAS was 0.925. Sensitivity and specificity were 83.3% and 85.7%, respectively. Cross-validation for our model showed that sensitivity, specificity, positive predictive value and negative predictive value of the model in diagnosis of PAS were 82.6%, 81.8%, 82.6% and 81.8%, respectively. Diagnosis of 37 cases were consistent with the “gold standard”, and the coincidence rate was 82.2% (37/45). Conclusion: The comprehensive scoring system established in this study can effectively diagnose PAS.
format	article
author	Yisu Gao Xuejiao Gao Jing Cai Fang Han Guixiang Xu Xuan Zhang Ting Zhang Lili Yu
author_facet	Yisu Gao Xuejiao Gao Jing Cai Fang Han Guixiang Xu Xuan Zhang Ting Zhang Lili Yu
author_sort	Yisu Gao
title	Prediction of placenta accreta spectrum by a scoring system based on maternal characteristics combined with ultrasonographic features
title_short	Prediction of placenta accreta spectrum by a scoring system based on maternal characteristics combined with ultrasonographic features
title_full	Prediction of placenta accreta spectrum by a scoring system based on maternal characteristics combined with ultrasonographic features
title_fullStr	Prediction of placenta accreta spectrum by a scoring system based on maternal characteristics combined with ultrasonographic features
title_full_unstemmed	Prediction of placenta accreta spectrum by a scoring system based on maternal characteristics combined with ultrasonographic features
title_sort	prediction of placenta accreta spectrum by a scoring system based on maternal characteristics combined with ultrasonographic features
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/e130a0f760cb4eaab0d237f58d8526e7
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Prediction of placenta accreta spectrum by a scoring system based on maternal characteristics combined with ultrasonographic features

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