Kenji Tanimura1, Mayumi Morizane1, Masashi Deguchi1, Yasuhiko Ebina1, Utaru Tanaka2, Yoshiko Ueno2, Kazuhiro Kitajima3, Tetsuo Maeda2, Kazuro Sugimura2, Hideto Yamada4. 1. Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan. 2. Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan. 3. Department of Radiology, Hyogo College of Medicine, Nishinomiya, Japan. 4. Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan. Electronic address: yhideto@med.kobe-u.ac.jp.
Abstract
INTRODUCTION: Placenta previa (PP) is one of the most significant risk factors for adherent placenta (AP). The aim of this study was to evaluate the diagnostic efficacy of a novel scoring system for predicting AP in pregnant women with PP. METHODS: This prospective cohort study enrolled 175 women with PP. The placenta previa with adherent placenta score (PPAP score) is composed of 2 categories: (1) past history of cesarean section (CS), surgical abortion, and/or uterine surgery; and (2) ultrasonography and magnetic resonance imaging findings. Each category is graded as 0, 1, 2, or 4 points, yielding a total score between 0 and 24. When women with PP had PPAP score ≥8, they were considered to be at a high risk for AP and received placement of preoperative internal iliac artery occlusion balloon catheters. If they were found to have AP during CS, they underwent hysterectomy or placenta removal using advanced bipolar with balloon catheter occlusion. The predictive accuracy of PPAP score was evaluated. RESULTS: In total, 23 of the 175 women with PP were diagnosed as having AP, histopathologically or clinically. Twenty-one of 24 women with PPAP score ≥8 had AP, whereas two of 151 women with PPAP score <8 had AP. The scoring system yielded 91.3% sensitivity, 98.0% specificity, 87.5% positive predictive value, and 98.7% negative predictive value for predicting AP in women with PP. DISCUSSION: This prospective study demonstrated that PPAP scoring system may be useful for predicting AP in women with PP.
INTRODUCTION: Placenta previa (PP) is one of the most significant risk factors for adherent placenta (AP). The aim of this study was to evaluate the diagnostic efficacy of a novel scoring system for predicting AP in pregnant women with PP. METHODS: This prospective cohort study enrolled 175 women with PP. The placenta previa with adherent placenta score (PPAP score) is composed of 2 categories: (1) past history of cesarean section (CS), surgical abortion, and/or uterine surgery; and (2) ultrasonography and magnetic resonance imaging findings. Each category is graded as 0, 1, 2, or 4 points, yielding a total score between 0 and 24. When women with PP had PPAP score ≥8, they were considered to be at a high risk for AP and received placement of preoperative internal iliac artery occlusion balloon catheters. If they were found to have AP during CS, they underwent hysterectomy or placenta removal using advanced bipolar with balloon catheter occlusion. The predictive accuracy of PPAP score was evaluated. RESULTS: In total, 23 of the 175 women with PP were diagnosed as having AP, histopathologically or clinically. Twenty-one of 24 women with PPAP score ≥8 had AP, whereas two of 151 women with PPAP score <8 had AP. The scoring system yielded 91.3% sensitivity, 98.0% specificity, 87.5% positive predictive value, and 98.7% negative predictive value for predicting AP in women with PP. DISCUSSION: This prospective study demonstrated that PPAP scoring system may be useful for predicting AP in women with PP.
Authors: Valeria Romeo; Francesco Verde; Laura Sarno; Sonia Migliorini; Mario Petretta; Pier Paolo Mainenti; Maria D'Armiento; Maurizio Guida; Arturo Brunetti; Simone Maurea Journal: Radiol Med Date: 2021-06-22 Impact factor: 3.469