Prenatal MRI for predicting prognosis after balloon occlusion of abdominal aorta-assisted cesarean section in patients with placenta accreta / 中国医学影像技术

ABSTRACT

Objective: To explore the value of prenatal MRI for predicting prognosis after balloon occlusion of abdominal aorta-assisted cesarean section (AABC-CS) in patients with placenta accreta. Methods: Prenatal MRI of 86 patients underwent AABC-CS due to placenta accreta were reviewed retrospectively. According to the prognosis, the patients were divided into good prognosis group (intraoperative blood loss <1 000 ml and unremoved uterus, n=50) and poor prognosis group (intraoperative blood loss ≥1 000 ml or uterus removed, n=36). MRI signs between the 2 groups were compared, and multivariate Logistic regression analysis was used to obtain the risk factors for predicting poor prognosis, and the predictive efficacy was calculated. Results: MRI signs of abnormal intraplacental vascularity, hypointense intraplacental bands, uterine recess, placenta percreta were significantly more common in poor prognosis group (all P<0.001). Multivariate Logistic regression analysis showed that abnormal intraplacental vascularity (odds ratio [OR]=15.78, P=0.015) and placenta percreta (OR=12.25, P=0.020) were risk factors for poor prognosis, with sensitivity and specificity of 77.78% (28/36), 62.00% (31/50) and 44.44% (16/36), 100% (50/50), respectively. Conclusion: Prenatal MRI signs of abnormal intraplacental vascularity and placenta percreta might be the predictors of intraoperative significant hemorrhage and hysterectomy after AABC-CS in patients with placenta accreta.