ABSTRACT
Objective ToinvestigatethevalueofpreoperativeMRIforplacentapreviainpredictionofmassivepostpartumhemorrhage. Methods AretrospectiveanalysisoftheclinicalhistoryandprenatalMRIfeaturesof362patientswithplacentapreviawereperformed. Ofthese,54casesexperiencedseverepostpartum hemorrhage.Results Univariateanalysisshowedthattheageofpregnantwomen (χ2=3.951,P=0.047),gestationalage(χ2=6.257,P=0.012),numberofcesareansections(χ2=36.372,P=0.001)andgemellary pregnancy(χ2=7.933,P=0.005)wereassociated with massivepostpartum hemorrhage.Amongthe MRIsigns,Uterinebulging (OR,46.712;95%CI,13.067-166.987),placentalprotrusionsign (OR,22.787;95% CI,4.595-113),andintroplacentalT2dark band(OR,14.757;95%CI,7.149-30.461)indicatedhighriskwithmassivepostpartumhemorrhage.Myometrialthinningorlocalized interruption,unevenplacentalsignal,abnormalbloodvesselsbelowtheplacenta,abundantbloodvesselsinloweruterusandcervix, cervicalshorteningandothersignsfortheevaluationofseverepostpartumhemorrhagewerealsostatisticallysignificant.Conclusion MRIcanpredictmostoftheseverepostpartumhemorrhagebeforesurgeryandisveryhelpfultoimprovethepatientprognosis.