Correlation of probability scores of placenta accreta on magnetic resonance imaging with hemorrhagic morbidity.
OBJECTIVE
To evaluate the hypothesis that assigning grades to magnetic resonance imaging (MRI) findings of suspected placenta accreta will correlate with hemorrhagic outcomes. We chose a single-center, retrospective, observational design.
Nulliparous or multiparous women who had antenatal placental MRI performed at a tertiary level academic hospital were included. Cases with antenatal placental MRI were included and compared with cases without MRI performed. Two radiologists assigned a probability score for accreta to each study. Estimated blood loss and transfusion requirements were compared among groups by the Kruskal-Wallis H test.


RESULTS
Thirty-five cases had placental MRI performed. MRI performance was associated with higher blood loss compared with the non-MRI group (2600 [1400-4500]mL vs 900[600-1500]mL, P<.001). There was no difference in estimated blood loss (P=.31) or transfusion (P=.57) among the MRI probability groups.


CONCLUSIONS
In cases of suspected placenta accreta, probability scores for antenatal placental MRI may not be associated with increasing degrees of hemorrhage. Continued research is warranted to determine the effectiveness of assigning probability scores for antenatal accreta imaging studies, combined with clinical indices of suspicion, in assisting with antenatal multidisciplinary team planning for operative management of this morbid condition.
Department of Anesthesiology, Northwestern University Feinberg School of Medicine, 251 E. Huron, Suite F5-704, Chicago, IL 60611, USA.
Grace
G
Lim
Department of Radiology, Northwestern University Feinberg School of Medicine, 676 North St. Clair Street, Suite 800, Chicago, IL 60611, USA.
Jeanne M
JM
Horowitz
Department of Radiology, Northwestern University Feinberg School of Medicine, 676 North St. Clair Street, Suite 800, Chicago, IL 60611, USA.
Senta
S
Berggruen
Department of Perinatal Pathology, Northwestern University Feinberg School of Medicine, 251 E. Huron, Suite 7-132a, Chicago, IL 60611, USA.
Linda M
LM
Ernst
Department of Perinatal Pathology, Northwestern University Feinberg School of Medicine, 251 E. Huron, Suite 7-132a, Chicago, IL 60611, USA.
Rebecca L
RL
Linn
Department of Anesthesiology, Northwestern University Feinberg School of Medicine, 251 E. Huron, Suite F5-704, Chicago, IL 60611, USA.
Bradley
B
Hewlett
Department of Anesthesiology, Northwestern University Feinberg School of Medicine, 251 E. Huron, Suite F5-704, Chicago, IL 60611, USA.
Jennifer
J
Kim
Department of Anesthesiology, Northwestern University Feinberg School of Medicine, 251 E. Huron, Suite F5-704, Chicago, IL 60611, USA.
Laurie A
LA
Chalifoux
Department of Anesthesiology, Northwestern University Feinberg School of Medicine, 251 E. Huron, Suite F5-704, Chicago, IL 60611, USA. Electronic address: r-mccarthy@northwestern.edu.
Robert J
RJ
McCarthy
D000328:Adult; D001803:Blood Transfusion; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D010921:Placenta Accreta / Q000000981:diagnostic imaging*; D006473:Postpartum Hemorrhage / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods*; D011336:Probability; D012189:Retrospective Studies
Accreta; Estimated blood loss; Grading; Hemorrhage; Magnetic resonance imaging; Prediction