Relationship of cervical length, morphology and maternal adverse outcomes in placenta praevia patients on the third trimester of pregnancy / 中国医学影像技术

ABSTRACT

Objective: To explore the relationship of cervical length (CL), morphology and maternal adverse outcomes in placenta praevia patients on the third trimester of pregnancy. Methods: Ultrasonic and clinical data of 84 singleton pregnancies confirmed as placenta praevia with cesarean section were retrospectively analyzed, including 20 cases with placenta accreta and 27 with massive hemorrhage. Taken 30 mm as the cut-off value of CL, the patients were divided into study group (CL≤30 mm, n=21) and control group (CL>30 mm, n=63).Then the relationship of CL, placenta praevia and massive hemorrhage during cesarean section were investigated. Results: CL was (26.9±2.9)mm in study group, lower than that in control group ([38.5±3.4]mm, P<0.001). The probability of placenta accreta and massive hemorrhage increased in patients with CL≤30 mm, cervical morphological incompleteness and cervical sinus (P<0.1), and CL≤30 mm was a risk factor for placental accreta. Taken CL=35.05 mm as the cut-off value, the best prediction of placental accrete and massive hemorrhage were obtained, with the sensitivity, specificity and AUC of the former was 81.3%, 90.0% and 0.890 (95%CI[0.813,0.967]), of the latter was 82.5%,74.1% and 0.814 (95%CI[0.717,0.912]), respectively. Conclusion: Cervical shortening (CL≤35.05 mm), cervical morphological incompleteness and cervical sinus on the third trimester are related to placenta accreta and massive hemorrhage during cesarean section, which might be used to evaluate placenta praevia and guiding adjustment of treatment plan.