دورية أكاديمية
Sonographic Predictors of Antepartum Bleeding in Placenta Previa.
| العنوان: | Sonographic Predictors of Antepartum Bleeding in Placenta Previa. |
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| المؤلفون: | Smith DD; Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, Ohio.; Department of Obstetrics and Gynecology, Kaiser Permanente Northern California, Modesto, California., Adesomo AA; Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, Ohio., Gonzalez-Brown VM; Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, Ohio., Russo J; Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, Ohio., Shellhaas C; Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, Ohio., Costanstine MM; Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, Ohio., Frey HA; Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, Ohio. |
| المصدر: | American journal of perinatology [Am J Perinatol] 2024 Jun; Vol. 41 (8), pp. 961-968. Date of Electronic Publication: 2024 Jan 30. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Thieme-Stratton Country of Publication: United States NLM ID: 8405212 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1098-8785 (Electronic) Linking ISSN: 07351631 NLM ISO Abbreviation: Am J Perinatol Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: New York, NY : Thieme-Stratton, 1983- |
| مواضيع طبية MeSH: | Placenta Previa*/diagnostic imaging , Uterine Hemorrhage*/diagnostic imaging , Uterine Hemorrhage*/etiology , Ultrasonography, Prenatal* , ROC Curve*, Humans ; Female ; Pregnancy ; Retrospective Studies ; Adult ; Logistic Models ; Predictive Value of Tests ; Cervix Uteri/diagnostic imaging ; Placenta/diagnostic imaging ; Gestational Age |
| مستخلص: | Objective: To evaluate the association between sonographic features of placenta previa and vaginal bleeding (VB). Study Design: Retrospective cohort study of women with placenta previa identified on ultrasound between 16 0/7 and 27 6/7 weeks gestation. Placental distance past the cervical os (DPO), placental thickness, edge angle, and cervical length (CL) were measured. The primary outcome was any VB and the secondary outcome was VB requiring delivery. Median values of the sonographic features were compared for each of the outcomes using the Mann-Whitney U test. Receiver operating characteristic curves were used to compare the predictive value of sonographic variables markers and to determine optimal cut points for each measurement. Logistic regression was used to estimate the association between each measure and the outcomes while controlling for confounders. Results: Of 149 women with placenta previa, 37% had VB and 15% had VB requiring delivery. Women with VB requiring delivery had significantly more episodes of VB than those who did not require delivery for VB (1.5, interquartile range [IQR] [1-3] vs 1.0 [1-5]; p = 0.001). In univariate analysis, women with VB had decreased CL (3.9 vs. 4.2 cm; p < 0.01) compared with those without. Women with VB requiring delivery had increased DPO (2.6 cm IQR [1.7-3.3] vs. 1.5 cm [1.1-2.4], p = 0.01) compared with those without. After adjusting for confounders, only CL < 4 cm remained independently associated with increased risk of VB (adjusted odds ratio: 2.27, 95% confidence interval [1.12-4.58], p = 0.01). None of the measures were predictive of either outcome (area under the curve < 0.65). Conclusion: Decreased CL may be associated with risk of VB in placenta previa. Key Points: · Placenta previa is associated with VB.. · Sonographic markers of placenta previa are associated with VB.. · CL is associated with VB in placenta previa, whereas placental DPO is associated with higher rates of bleeding leading to delivery.. Competing Interests: None declared. (Thieme. All rights reserved.) |
| تواريخ الأحداث: | Date Created: 20240130 Date Completed: 20240520 Latest Revision: 20240520 |
| رمز التحديث: | 20240521 |
| DOI: | 10.1055/a-2257-3106 |
| PMID: | 38290558 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1098-8785 |
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| DOI: | 10.1055/a-2257-3106 |