Correlation of An Ultrasonic Scoring System and Intraoperative Blood Loss in Placenta Accreta Spectrum Disorders: A Retrospective Cohort Study

Objective This study aims to investigate the correlation of an ultrasonic scoring system with intraoperative blood loss(IBL) in placenta accreta spectrum(PAS) disorders.Methods A retrospective cohort study was conducted between January 2015 and November 2019.Clinical data for patients with PAS have been obtained from medical records. Generalized additive models were used to explore the nonlinear relationships between ultrasonic scores and IBL. Logistic regressions were used to determine the differences in the risk of IBL ≥ 1,500 m L among groups with different ultrasonic scores.Results A total of 332 patients participated in the analysis. Generalized additive models showed a significant positive correlation between score and blood loss. The amount of IBL was increased due to the rise in the ultrasonic score. All cases were divided into three groups according to the scores(low score group: ≤ 6 points, n = 147;median score group: 7-9 points, n = 126;and high score group: ≥ 10 points, n = 59). Compared with the low score group, the high score group showed a higher risk of IBL≥ 1,500 m L [odds ratio, 15.09;95% confidence interval(3.85, 59.19);P ≤ 0.001] after a multivariable adjustment.Conclusions The risk of blood loss equal to or greater than 1,500 m L increases further when ultrasonic score greater than or equal to 10 points, the preparation for transfusion and referral mechanism should be considered.

APPLICATION OF TRANSVAGINAL CDFI IN THE DISTIN- GUISHMENT BETWEEN BENIGN AND MALIGNANT OVARIAN TUMOR

Objective To assess the value of transvaginal CDFI in the diagnosis of malignant ovariantumors and to discriminate the benign from malignant ovarian tumors. Methods 96 patients pelvic masses were studied by transvaginal ultrasonograph mass scoring, and by CDFI through pulsatility index (PI) and resistance index (RI) of peripheral blood flow of mass analyses. Results Mass ultrasonic scoring : scoring >9, 91.9% masses were malignant tumors. Scoring ≤<9, 91.5% masses were benign tumors. PI and Rl of peripheral blood flow of masses were detected by CDFI: Pl< 1 .0 . 92.5% cases; RI<0.5, 97.4% cases were malignant tumors. The diagnosis match rate of malignant ovarian tumors was 97.0% . The diagnosis match rate of benign ovarian tumor was 96 .2% . The diagnosis match rate was improved. Conclusion Ovarian mass ultrasonic scoring>9 and PI< 1 .0 , RI<0 .5 of mass peripheral blood flow are the special ultrasonic features of malignant ovarian tumor and the better methods to distinguish the benign ovarian tumor from the malignant one.