Enhancing postpartum hemorrhage prediction in pernicious placenta previa: a comparative study of magnetic resonance imaging and ultrasound nomogram
Objective: To explore the risk factors of postpartum hemorrhage (PPH) in patients with pernicious placenta previa (PPP) and to develop and validate a clinical and imaging-based predictive model.Methods: A retrospective analysis was conducted on patients diagnosed surgically and pathologically with P...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2023-08-01
|
| Series: | Frontiers in Physiology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fphys.2023.1177795/full |
| _version_ | 1797751317703163904 |
|---|---|
| author | Zixuan Song Pengyuan Wang Lue Zou Yangzi Zhou Xiaoxue Wang Tong Liu Dandan Zhang |
| author_facet | Zixuan Song Pengyuan Wang Lue Zou Yangzi Zhou Xiaoxue Wang Tong Liu Dandan Zhang |
| author_sort | Zixuan Song |
| collection | DOAJ |
| description | Objective: To explore the risk factors of postpartum hemorrhage (PPH) in patients with pernicious placenta previa (PPP) and to develop and validate a clinical and imaging-based predictive model.Methods: A retrospective analysis was conducted on patients diagnosed surgically and pathologically with PPP between January 2018 and June 2022. All patients underwent PPP magnetic resonance imaging (MRI) and ultrasound scoring in the second trimester and before delivery, and were categorized into two groups according to PPH occurrence. The total imaging score and sub-item prediction models of the MRI risk score/ultrasound score were used to construct Models A and B/Models C and D. Models E and F were the total scores of the MRI combined with the ultrasound risk and sub-item prediction model scores. Model G was based on the subscores of MRI and ultrasound with the introduction of clinical data. Univariate logistic regression analysis and the logical least absolute shrinkage and selection operator (LASSO) model were used to construct models. The receiver operating characteristic curve andision curve analysis (DCA) were drawn, and the model with the strongest predictive ability and the best clinical effect was selected to construct a nomogram. Internal sampling was used to verify the prediction model’s consistency.Results: 158 patients were included and the predictive power and clinical benefit of Models B and D were better than those of Models A and C. The results of the area under the curve of Models B, D, E, F, and G showed that Model G was the best, which could reach 0.93. Compared with Model F, age, vaginal hemorrhage during pregnancy, and amniotic fluid volume were independent risk factors for PPH in patients with PPP (p < 0.05). We plotted the DCA of Models B, D, E, F, and G, which showed that Model G had better clinical benefits and that the slope of the calibration curve of Model G was approximately 45°.Conclusion: LASSO regression nomogram based on clinical risk factors and multiple conventional ultrasound plus MRI signs has a certain guiding significance for the personalized prediction of PPH in patients with PPP before delivery. |
| first_indexed | 2024-03-12T16:45:40Z |
| format | Article |
| id | doaj.art-8b670f740fa1419fbf8962d39acc6e43 |
| institution | Directory Open Access Journal |
| issn | 1664-042X |
| language | English |
| last_indexed | 2024-03-12T16:45:40Z |
| publishDate | 2023-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Physiology |
| spelling | doaj.art-8b670f740fa1419fbf8962d39acc6e432023-08-08T12:25:18ZengFrontiers Media S.A.Frontiers in Physiology1664-042X2023-08-011410.3389/fphys.2023.11777951177795Enhancing postpartum hemorrhage prediction in pernicious placenta previa: a comparative study of magnetic resonance imaging and ultrasound nomogramZixuan Song0Pengyuan Wang1Lue Zou2Yangzi Zhou3Xiaoxue Wang4Tong Liu5Dandan Zhang6Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, ChinaDepartment of Radiology, Shengjing Hospital of China Medical University, Shenyang, ChinaDepartment of Radiology, Shengjing Hospital of China Medical University, Shenyang, ChinaDepartment of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, ChinaDepartment of Health Management, Shengjing Hospital of China Medical University, Shenyang, ChinaDepartment of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, ChinaDepartment of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, ChinaObjective: To explore the risk factors of postpartum hemorrhage (PPH) in patients with pernicious placenta previa (PPP) and to develop and validate a clinical and imaging-based predictive model.Methods: A retrospective analysis was conducted on patients diagnosed surgically and pathologically with PPP between January 2018 and June 2022. All patients underwent PPP magnetic resonance imaging (MRI) and ultrasound scoring in the second trimester and before delivery, and were categorized into two groups according to PPH occurrence. The total imaging score and sub-item prediction models of the MRI risk score/ultrasound score were used to construct Models A and B/Models C and D. Models E and F were the total scores of the MRI combined with the ultrasound risk and sub-item prediction model scores. Model G was based on the subscores of MRI and ultrasound with the introduction of clinical data. Univariate logistic regression analysis and the logical least absolute shrinkage and selection operator (LASSO) model were used to construct models. The receiver operating characteristic curve andision curve analysis (DCA) were drawn, and the model with the strongest predictive ability and the best clinical effect was selected to construct a nomogram. Internal sampling was used to verify the prediction model’s consistency.Results: 158 patients were included and the predictive power and clinical benefit of Models B and D were better than those of Models A and C. The results of the area under the curve of Models B, D, E, F, and G showed that Model G was the best, which could reach 0.93. Compared with Model F, age, vaginal hemorrhage during pregnancy, and amniotic fluid volume were independent risk factors for PPH in patients with PPP (p < 0.05). We plotted the DCA of Models B, D, E, F, and G, which showed that Model G had better clinical benefits and that the slope of the calibration curve of Model G was approximately 45°.Conclusion: LASSO regression nomogram based on clinical risk factors and multiple conventional ultrasound plus MRI signs has a certain guiding significance for the personalized prediction of PPH in patients with PPP before delivery.https://www.frontiersin.org/articles/10.3389/fphys.2023.1177795/fullpernicious placenta previapostpartum hemorrhageLASSO analysisclinical prediction modelnomogram |
| spellingShingle | Zixuan Song Pengyuan Wang Lue Zou Yangzi Zhou Xiaoxue Wang Tong Liu Dandan Zhang Enhancing postpartum hemorrhage prediction in pernicious placenta previa: a comparative study of magnetic resonance imaging and ultrasound nomogram Frontiers in Physiology pernicious placenta previa postpartum hemorrhage LASSO analysis clinical prediction model nomogram |
| title | Enhancing postpartum hemorrhage prediction in pernicious placenta previa: a comparative study of magnetic resonance imaging and ultrasound nomogram |
| title_full | Enhancing postpartum hemorrhage prediction in pernicious placenta previa: a comparative study of magnetic resonance imaging and ultrasound nomogram |
| title_fullStr | Enhancing postpartum hemorrhage prediction in pernicious placenta previa: a comparative study of magnetic resonance imaging and ultrasound nomogram |
| title_full_unstemmed | Enhancing postpartum hemorrhage prediction in pernicious placenta previa: a comparative study of magnetic resonance imaging and ultrasound nomogram |
| title_short | Enhancing postpartum hemorrhage prediction in pernicious placenta previa: a comparative study of magnetic resonance imaging and ultrasound nomogram |
| title_sort | enhancing postpartum hemorrhage prediction in pernicious placenta previa a comparative study of magnetic resonance imaging and ultrasound nomogram |
| topic | pernicious placenta previa postpartum hemorrhage LASSO analysis clinical prediction model nomogram |
| url | https://www.frontiersin.org/articles/10.3389/fphys.2023.1177795/full |
| work_keys_str_mv | AT zixuansong enhancingpostpartumhemorrhagepredictioninperniciousplacentapreviaacomparativestudyofmagneticresonanceimagingandultrasoundnomogram AT pengyuanwang enhancingpostpartumhemorrhagepredictioninperniciousplacentapreviaacomparativestudyofmagneticresonanceimagingandultrasoundnomogram AT luezou enhancingpostpartumhemorrhagepredictioninperniciousplacentapreviaacomparativestudyofmagneticresonanceimagingandultrasoundnomogram AT yangzizhou enhancingpostpartumhemorrhagepredictioninperniciousplacentapreviaacomparativestudyofmagneticresonanceimagingandultrasoundnomogram AT xiaoxuewang enhancingpostpartumhemorrhagepredictioninperniciousplacentapreviaacomparativestudyofmagneticresonanceimagingandultrasoundnomogram AT tongliu enhancingpostpartumhemorrhagepredictioninperniciousplacentapreviaacomparativestudyofmagneticresonanceimagingandultrasoundnomogram AT dandanzhang enhancingpostpartumhemorrhagepredictioninperniciousplacentapreviaacomparativestudyofmagneticresonanceimagingandultrasoundnomogram |