Diagnostic accuracy of a specialized pro forma in assessing morbidly adherent placenta in correlation to intra-operative findings

IF 1.6 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of Obstetrics and Gynaecology Research Pub Date : 2025-05-06 DOI:10.1111/jog.16314

Fatma F. Ismail, Hassan M. Gaafar, Moutaz M. Elsherbini, Abdalla Mousa

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引用次数: 0

Abstract

Objectives

To assess the clinical value of ultrasound criteria for the “Morbidly Adherent Placenta” (MAP) and the diagnostic accuracy of a customized “pro forma” in predicting MAP, its extent, and its relationship to intra-operative results.

Methods

Twenty-one pregnant women with a high possibility of placenta accreta were included in the study. Gray scale transabdominal and transvaginal ultrasound with color Doppler were done to confirm the MAP diagnosis and evaluate the signs of placental invasion. The ultrasound findings were compared with the operative details to predict placental invasion (focal or diffuse) and vascularity of the lower uterine segment to assess the clinical significance of the customized “pro forma.”

Results

There was a good accuracy of ultrasound signs to detect the vascularity of the lower uterine segment with a sensitivity of 94.12%, specificity of 25%, positive predictive value (PPV) of 84.21%, negative predictive value (NPV) of 50%, and accuracy of 80.95%; however, it was insignificant (p = 0.352). Additionally, we found a good accuracy of ultrasound signs to detect the degree of placental invasion (focal or diffuse), with a sensitivity of 71.43%, specificity of 100%, PPV of 100%, NPV of 63.64%, and accuracy of 80.95%, which was significant (p = 0.004).

Conclusion

This customized “pro forma” has satisfactory accuracy in predicting MAP cases with anterior placenta previa or anterior low-lying placenta.

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一种评估病态附着性胎盘的专业形式的诊断准确性与术中发现的相关性

目的探讨超声诊断“病态附着性胎盘”（病态附着性胎盘，MAP）的临床价值，以及定制“形式”预测MAP的准确性、程度及其与术中结果的关系。方法选取21例高可能性胎盘增生的孕妇作为研究对象。采用彩色多普勒经腹、经阴道灰度超声确认MAP诊断并评价胎盘侵犯征象。将超声结果与手术细节进行比较，以预测胎盘侵犯（局灶性或弥漫性）和子宫下段血管状况，以评估定制的“形式”的临床意义。结果超声征像检测子宫下段血管的准确性较好，敏感性为94.12%，特异性为25%，阳性预测值（PPV）为84.21%，阴性预测值（NPV）为50%，准确率为80.95%；但差异不显著（p = 0.352）。此外，我们发现超声征象对胎盘侵犯程度（局灶性或弥漫性）的检测准确性较好，敏感性为71.43%，特异性为100%，PPV为100%，NPV为63.64%，准确率为80.95%，差异有统计学意义（p = 0.004）。结论该定制的“预表”对MAP合并前置胎盘或前低位胎盘的预测具有满意的准确性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Obstetrics and Gynaecology Research 医学-妇产科学

CiteScore

3.10

自引率

0.00%

发文量

376

审稿时长

3-6 weeks

期刊介绍： The Journal of Obstetrics and Gynaecology Research is the official Journal of the Asia and Oceania Federation of Obstetrics and Gynecology and of the Japan Society of Obstetrics and Gynecology, and aims to provide a medium for the publication of articles in the fields of obstetrics and gynecology. The Journal publishes original research articles, case reports, review articles and letters to the editor. The Journal will give publication priority to original research articles over case reports. Accepted papers become the exclusive licence of the Journal. Manuscripts are peer reviewed by at least two referees and/or Associate Editors expert in the field of the submitted paper.