Is it possible to predict severe postpartum hemorrhage and the need for massive transfusion in placenta previa cases?

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dc.authorid0000-0002-4940-8862
dc.contributor.authorKole, Emre
dc.contributor.authorAkar, Bertan
dc.contributor.authorDoger, Emek
dc.contributor.authorKole, Merve Cakir
dc.contributor.authorAnik, Yonca
dc.contributor.authorCaliskan, Eray
dc.date.accessioned2026-01-24T12:26:46Z
dc.date.available2026-01-24T12:26:46Z
dc.date.issued2025
dc.departmentAlanya Alaaddin Keykubat Üniversitesi
dc.description.abstractObjectives: The aim was to construct a reliable working model for patients with placenta previa (PP) that aids in the prediction of postpartum bleeding potential with data from antenatal imaging studies using both ultrasound (US) and magnetic resonance imaging (MRI). Material and methods: Forty-three patients with PP were evaluated initially with the US and then by 3-Tesla MRI. The placenta accreata index (PAI) was used during the US evaluation in order to define the risks. Uterine bulging, heterogeneous signal, dark placental bands, focal interruption of myometrium and tenting of bladder wall were regarded as predictive criteria in MRI evaluation. The correlation between the findings from US and MRI studies and subsequent haemorrhage, < 1000 mL, > 1000 mL and severe haemorrhage (> 2000 mL) and massive transfusion [> 5 units of red blood cells (RBC)] were used to build this predictive model. The findings from the imaging studies were also confirmed histopathologically. Results: In the multivariate analysis of data from patients stratified by bleed size either < 1000 mL or > 1000 mL, none of the MRI and ultrasound findings were found to be predictive. The multivariate analysis was done using the second stratification cut-point of 2000 mL, in patients bleeding > 2000 mL PAI values [OR: 2.3 (1.4-3.8)] and overall MRI reported placenta accreata spectrum [OR: 4.9 (1.8-12.9)] were found to be predictive. While MRI findings were not discriminative between transfusion groups, grade 3 loculation on US examination was found to be predictive for the need of transfusion of > 5 units [OR: 67.5 (8.2-549.4)]. There were no cases needing hysterectomy. Conclusions: Ultrasound and MRI findings in cases of PP can be helpful in predicting postpartum bleeding.
dc.identifier.doi10.5603/gpl.103049
dc.identifier.endpage313
dc.identifier.issn0017-0011
dc.identifier.issn2543-6767
dc.identifier.issue4
dc.identifier.pmid40070253
dc.identifier.scopus2-s2.0-105004768284
dc.identifier.scopusqualityQ3
dc.identifier.startpage308
dc.identifier.urihttps://doi.org/10.5603/gpl.103049
dc.identifier.urihttps://hdl.handle.net/20.500.12868/4924
dc.identifier.volume96
dc.identifier.wosWOS:001484564600001
dc.identifier.wosqualityQ4
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherVia Medica
dc.relation.ispartofGinekologia Polska
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.snmzKA_WoS_20260121
dc.subjectplacenta previa
dc.subjectplacenta accreata spectrum
dc.subjectpostpartum haemorrhage
dc.subjectplacenta accreata index
dc.titleIs it possible to predict severe postpartum hemorrhage and the need for massive transfusion in placenta previa cases?
dc.typeArticle

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