A novel scoring system for predicting adherent placenta in women with placenta previa
A novel scoring system for predicting adherent placenta in women with placenta previa
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DOI：
10.1016/j.placenta.2018.02.005
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发表时间：
2018-04-01
期刊：
影响因子：
3.8
通讯作者：
Yamada, Hideto
中科院分区：
文献类型：
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作者：
Tanimura, Kenji;Morizane, Mayumi;Yamada, Hideto
前言：前置胎盘（PP）是粘连胎盘（AP）的最重要危险因素之一。本研究的目的是评估一种新的评分系统的诊断效果，预测AP妊娠妇女PP。方法：这项前瞻性队列研究纳入了175名妇女PP。前置胎盘伴胎盘粘连评分（PPAP评分）包括2类：（1）剖宫产（CS）、手术流产和/或子宫手术史;（2）超声和磁共振成像结果。每个类别分为0、1、2或4分，总分在0到24分之间。当患有PP的女性PPAP评分>= 8时，她们被认为是AP的高风险，并接受术前髂内动脉闭塞球囊导管的放置。如果在CS期间发现AP，则使用高级双极球囊导管闭塞进行子宫切除术或胎盘切除术。PPAP评分的预测准确性进行了评估。结果：在175例PP中，共有23例被诊断为AP，病理组织学或临床。PPAP评分≥ 8分的24名女性中有21名患有AP，而PPAP评分≥ 8分的151名女性中有2名患有AP。
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