Antenatal 3D power Doppler ultrasound in predicting bleeding volume in patients with placenta previa undergoing cesarean surgery / 中国医学影像技术

ABSTRACT

Objective: To explore the value of three-dimensional power Doppler ultrasound (3D-PDU) in predicting bleeding volume during cesarean surgery in patients with placenta previa. Methods: Clinical data of 141 patients with placenta previa who underwent 3D-PDU examinations before cesarean surgery and the bleeding volume during cesarean surgery were retrospectively reviewed. The patients were classified into implanted placenta previa group (n=66) and non-implanted placenta previa group (n=75). The differences of vascularization index (VI), flow index (FI), vascularization flow index (VFI) and bleeding volume were compared between the 2 groups, and the correlation was analyzed. ROC curve was used to evaluate the efficacy of each index in predicting bleeding volume during cesarean surgery. Results: Antenatal VI, FI, VFI and bleeding volume of the implanted placenta previa group were higher than those of non-implanted placenta previa group (all P<0.05). In all 141 patients, VI and VFI were positively correlated with the bleeding volume during cesarean surgery (r=0.702, 0.737, both P<0.001). In implanted placenta previa group, VI, FI and VFI were positively correlated with the bleeding volume in cesarean section (r=0.680, 0.492, 0.722, all P<0.001). In non-implanted placenta previa group, VI and VFI were positively correlated with the bleeding volume during cesarean surgery (r=0.861, 0.832, both P<0.001). The area under ROC curve of VI, FI and VFI in all 141 patients were 0.911, 0.798 and 0.937 (all P<0.001), in implanted placenta previa group were 0.966, 0.722 and 0.938 (all P<0.05), while in non-implanted placenta previa group were 0.885, 0.856 and 0.966, respectively (all P<0.001). Conclusion: Antenatal 3D-PDU can be applied in predicting bleeding volume in patients with placenta previa during cesarean surgery.