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- Title
Bedside risk estimation of morbidly adherent placenta using simple calculator.
- Authors
Maymon, R.; Melcer, Y.; Pekar-Zlotin, M.; Shaked, O.; Cuckle, H.; Tovbin, J.
- Abstract
<bold>Purpose: </bold>To construct a calculator for 'bedside' estimation of morbidly adherent placenta (MAP) risk based on ultrasound (US) findings.<bold>Materials and Methods: </bold>This retrospective study included all pregnant women with at least one previous cesarean delivery attending in our US unit between December 2013 and January 2017. The examination was based on a scoring system which determines the probability for MAP.<bold>Results: </bold>The study population included 471 pregnant women, and 41 of whom (8.7%) were diagnosed with MAP. Based on ROC curve, the most effective US criteria for detection of MAP were the presence of the placental lacunae, obliteration of the utero-placental demarcation, and placenta previa. On the multivariate logistic regression analysis, US findings of placental lacunae (OR = 3.5; 95% CI, 1.2-9.5; P = 0.01), obliteration of the utero-placental demarcation (OR = 12.4; 95% CI, 3.7-41.6; P < 0.0001), and placenta previa (OR = 10.5; 95% CI, 3.5-31.3; P < 0.0001) were associated with MAP. By combining these three parameters, the receiver operating characteristic curve was calculated, yielding an area under the curve of 0.93 (95% CI, 0.87-0.97). Accordingly, we have constructed a simple calculator for 'bedside' estimation of MAP risk. The calculator is mounted on the hospital's internet website ( http://www.assafh.org/Pages/PPCalc/index.html ). The risk estimation of MAP varies between 1.5 and 87%.<bold>Conclusions: </bold>The present calculator enables a simple 'bedside' MAP estimation, facilitating accurate and adequate antenatal risk assessment.
- Subjects
RISK assessment; CALCULATORS; PLACENTA; EMBRYOLOGY; CESAREAN section
- Publication
Archives of Gynecology & Obstetrics, 2018, Vol 297, Issue 3, p631
- ISSN
0932-0067
- Publication type
journal article
- DOI
10.1007/s00404-017-4644-x