Clinical value of a risk model based on ultrasonic signs and clinical risk factors in predicting severe intraoperative hemorrhage in patients with pernicious placenta previa
Clinical value of a risk model based on ultrasonic signs and clinical risk factors in predicting severe intraoperative hemorrhage in patients with pernicious placenta previa
Objective To construct a risk model based on ultrasonic signs and clinical high-risk factors,and to explore its clinical value in predicting severe intraoperative hemorrhage in patients with pernicious placenta previa.Methods A total of 80 patients with pernicious placenta previa were selected and divided into a mild hemorrhage group(hemorrhage volume<1000 ml,27 cases)and a severe hemorrhage group(hemorrhage volume≥1000 ml,53 cases)according to the intraoperative hemorrhage volume.The differences in clinical risk factors and ultrasonic signs between the two groups were compared.Binary Logistic regression analysis was used to screen the independent risk factors for severe intraoperative hemorrhage in patients with pernicious placenta previa,and a risk model was constructed.Receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic efficacy of the model in predicting severe intraoperative hemorrhage in patients with pernicious placenta previa.Results In the mild hemorrhage group,12 cases(44.44%)without placenta accreta spectrum disorders,13 cases(48.15%)with placental adhesion,and 2 cases(7.41%)with placenta accreta.In the severe hemorrhage group,11 cases(20.76%)with placental adhesion,24 cases(45.28%)with placenta accreta,and 18 cases(33.96%)with placenta percreta.A total of 7 cases underwent hysterectomy,all of whom were in the severe hemorrhage group.There were significant differences in cesarean section times,disappearance of retroplacental space,placental lacunae,blood flow at uterovesical junction,interruption of bladder line and cervical involvement between the mild hemorrhage group and the severe hemorrhage group(all P<0.05).Binary Logistic regression analysis showed that the cesarean section times and blood flow at the uterovesical junction were independent risk factors for severe intraoperative hemorrhage in patients with pernicious placenta previa(OR=10.560,15.831,both P<0.05).The area under the curve of constructed risk model and blood flow at uterovesical junction for predicting severe intraoperative hemorrhage in patients with pernicious placenta previa were 0.805 and 0.768,respectively,which were higher than that of cesarean section times(0.632),there were significant differences(both P<0.05).Conclusion The risk model based on the cesarean sections times and the blood flow at uterovesical junction has good clinical value in predicting severe intraoperative hemorrhage in patients with pernicious placenta previa.
维普
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