Placenta accreta spectrum and hysterectomy prediction using MRI radiomic features

Leitch, Ka'Toria; Shahedi, Maysam; Dormer, James D.; Quyen, N.; Xi, Yin; Lewis, Matthew; Herrera, Christina L.; Spong, Catherine Y.; Madhuranthakam, Ananth J.; Twickler, Diane M.; Fei, Baowei

doi:10.1117/12.2611587

Cited by 1 publication

(1 citation statement)

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“…Placenta accreta spectrum is one of the most serious long-term complications of cesarean section, which may result in heavy postpartum hemorrhage. Due to endometrial damage, poor wound healing, and other factors, the villi and placenta are more likely to invade the muscle layer and even the serous layer in PAS patients who undergo cesarean section, resulting in placenta implantation and incomplete separation of the placenta during delivery (7)(8)(9). The rapture of the placental marginal sinus can result in severe bleeding during the operation, leading to severe complications such as disseminated intravascular coagulation, hysterectomy, infection, and even death (10)(11)(12)(13).…”

Section: Introductionmentioning

confidence: 99%

Risk factors of emergency cesarean section in pregnant women with severe placenta accreta spectrum: a retrospective cohort study

Zhao

Yang

et al. 2023

Front. Med.

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IntroductionPlacenta accreta spectrum (PAS) may cause enormous and potentially life-threatening hemorrhage in the intrapartum and postpartum periods in emergency cesarean section. How to reduce the occurrence of emergency cesarean section in patients with severe PAS is the key to reducing the adverse outcomes of them. This study aimed to investigate the impact of emergency cesarean section on the perioperative outcomes of pregnant women with PAS and neonates, and also aimed to explore the risk factors of emergency cesarean section in pregnant women with PAS.Materials and methodsA retrospective investigation was conducted among 163 pregnant women with severe PAS. Of these, 72 were subjected to emergency cesarean sections. Data on the perioperative characteristics of the mothers and neonates were collected. Multivariable linear regression analysis was used to detect associations between maternal and perioperative characteristics and volume of intraoperative bleeding. Binary logical regression was used to analyze the association between maternal preoperative characteristics and emergency cesarean section. Linear regression analysis is used to analyze the relationship between gestational age and emergency cesarean section.ResultsThe risks of emergency cesarean section increase 98, 112, 124, and 62% when the pregnant women with PAS accompanied by GHD, ICP, more prior cesarean deliveries and more severe PAS type, respectively. Noteworthy, the risk of emergency cesarean section decreases 5% when pre-pregnancy BMI increases 1 kg/m2 (OR: 0.95; CI: 0.82, 0.98; p = 0.038). Moreover, there is no significant linear correlation between emergency cesarean section and gestational age.ConclusionGHD, ICP, multiple prior cesarean deliveries and severe PAS type may all increase the risk of emergency cesarean section for pregnant women with PAS, while high pre-pregnancy BMI may be a protective factor due to less activity level. For pregnant women with severe PAS accompanied by these high risk factors, more adequate maternal and fetal monitoring should be carried out in the third trimester to reduce the risk of emergency cesarean section.

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