WU Xiuli,ZHOU Rongzhen,ZHENG Ke, et al. MRI features of postpartum hemorrhage in gravida with placenta accreta sepctrum[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2021, 51(10): 827-831.
Abstract：Objective: To investigate the MRI features of gravida with PAS with an analysis of the risk factors of postpartum hemorrhage after cesarean section. Methods: The clinical data and MRI images of 100 gravida with PAS who underwent prenatal MRI examination and delivered in Taizhou Hospital Affiliated to Wenzhou Medical University from September 2016 to March 2021 were retrospectively analyzed. Thirty-seven gravida with postpartum hemorrhage≥1 000 mL were selected as the observation group (including 16 patients with hysterectomy), and 63 gravida with blood loss less than 1 000 mL were selected as the control group. The differences of MRI features between the two groups were compared, including T2-dark intraplacenta bands,placental/uterine bulge, loss of retroplacental T2-hypointense, myometrium thinning, bladder wall interruption,focal exophytic mass, abnormal vascularization of placental bed, placenta previa and catastrophe placenta previa,and the independent risk factors of postpartum hemorrhage were analyzed and evaluated. Results: There was statistical difference between the two groups in 8 MRI features except myometrium thinning (P<0.05). Binary Logistic regression analysis showed that T2-dark intraplacenta bands (OR=10.889, 95%CI: 1.021-116.159) and catastrophe placenta previa (OR=5.458, 95%CI: 1.284-23.200) were independent risk factors for postpartum hemorrhage in gravida with PAS (P<0.05). Conclusion: T2-dark intraplacenta bands and catastrophe placenta previa on prenatal MRI prompted an increased risk of postpartum hemorrhage in gravida with PAS, which should be paid attention to by obstetrician.
