Bedside risk estimation of morbidly adherent placenta using simple calculator

Area of Science:

• Maternal-Fetal Medicine
• Diagnostic Imaging
• Obstetrics

Background:

• Morbidly adherent placenta (MAP) poses significant risks during pregnancy, particularly in women with prior cesarean deliveries.
• Accurate antenatal risk assessment is crucial for managing MAP and improving maternal outcomes.

Purpose of the Study:

• To develop a bedside calculator for estimating the risk of morbidly adherent placenta (MAP).
• To utilize specific ultrasound (US) findings to predict MAP probability in high-risk pregnancies.

Main Methods:

• Retrospective study of 471 pregnant women with at least one prior cesarean delivery.
• Analysis of ultrasound findings including placental lacunae, utero-placental demarcation obliteration, and placenta previa.
• Development of a scoring system and a calculator based on multivariate logistic regression and ROC curve analysis.

Main Results:

• 41 out of 471 women (8.7%) were diagnosed with MAP.
• Placental lacunae (OR=3.5), obliterated utero-placental demarcation (OR=12.4), and placenta previa (OR=10.5) were significant predictors of MAP.
• The developed calculator demonstrated high accuracy with an area under the ROC curve of 0.93.

Conclusions:

• A simple bedside calculator for MAP risk estimation has been developed.
• This tool facilitates accurate and adequate antenatal risk assessment for MAP.
• The calculator is accessible online for clinical use.