Objective To investigate the clinical application value of magnetic resonance imaging(MRI)in predicting placenta previa with placenta accreta and postpartum hemorrhage.Methods A total of 228 patients with placenta previa confirmed by cesarean section or pathology were retrospectively analyzed for complete clinical data and prenatal MRI ima-ging data,and were divided into two groups:one without placenta accreta(n=102)and one with placenta accreta(n=126).They were also divided into two groups according to the presence or absence of postpartum hemorrhage(n=149)and postpartum hemorrhage(n=79).The differences in MRI findings between the two groups were compared by x2 test or Fisher exact probability method.Kappa consistency test was used to evaluate the diagnostic efficacy of MRI in the diagnosis of placenta implantation before delivery,and multivariate Logistic regression model was used to analyze the independent risk factors of MRI signs in the evaluation of postpartum hemorrhage.Results There were statistical significance in MRI find-ings between the group without placenta implantation and the group with placenta implantation,except for placenta ischemic infarction(P＜0.05).The results of prenatal MRI diagnosis were in good agreement with those seen in cesarean section and postoperative pathological diagnosis(Kappa=0.817).In addition to placental ischemic infarction,the other nine MRI signs were statistically significant(P＜0.05).Logistic regression model was used for multivariate analysis,and the results showed that the abnormal fetal blood vessel width in the placenta and the anterior wall of the placenta covering below the top of the limb were statistically significant(P＜0.05).Conclusion MRI diagnosis of placenta implantation in prenatal is consistent with pathological diagnosis after cesarean section,and has certain clinical application value in predicting postpar-tum hemorrhage.
Prenatal magnetic resonance imagingPlacental implantationPlacenta previaPostpartum hemorrhage
维普
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