Prenatal MRI and Ultrasound Features of Pernicious Placenta Previa and Correlation with Postpartum Bleeding
ZHAO Ruixin
KANG Rui
GUO Juanni
WANG Ping
YANG Jinjun
BIAN Yuan
LI Xina
Abstract：Objective To analyze the correlation between prenatal magnetic resonance imaging(MRI)and ultrasound features and postpartum bleeding in pernicious placenta previa(PPP),and to evaluate the clinical value of combined imaging diagnosis.Methods A retrospective analysis was conducted on 113 pregnant women with PPP admitted to the First People's Hospital of Xianyang from January 2022 to December 2024 were retrospectively analyzed as observation group and 96 pregnant women with normal placenta were included in control group.MRI and color Doppler ultrasound were performed before delivery in both groups.The differences in MRI and ultrasound imaging findings between the two groups were compared.The diagnostic value of MRI,ultrasound,and their combination for PPP was evaluated.Based on the median postpartum bleeding volume in PPP patients,the observation group was divided into a bleeding group(n=75)and a non-bleeding group(n=38).Differences in MRI/ultrasound imaging signs and quantitative parameters between the two groups were compared,and the relationship between these parameters and postpartum bleeding volume was analyzed.Results The observation group had higher rates of abnor-mal MRI signs and ultrasound imaging signs than the control group(P＜0.05).MRI findings included:uneven placenta signals,vascular abnormalities,uterine bulge,hump-shaped placenta,and bladder wall changes,abnormal placental vasculature,and fog-like echos.MRI had significantly higher diagnostic efficiency than ultrasound,and while the combination of both showed the highest sensitivity,(95.58％),specificity(93.75％),and accuracy(94.74％)(P＜0.05).The bleeding group had higher rates of abnormal imaging signs than the non-bleeding group(P＜0.05).Both MRI sign scores(r=0.479)and ultrasound scores(r=0.519)were positively correlated with postpartum bleeding volume(P＜0.001).Conclusion PPP patients are at high risk of bleeding.MRI and ultrasound signs are closely related to postpartum bleeding,with MRI demonstrating superior diagnostic performance.Combined use of both modalities provides higher diagnostic efficiency,offering a basis for clinical bleeding risk assessment.
Keywords：Pernicious placenta previaMagnetic resonance imagingPostpartum bleedingColor Doppler ultrasound
Publication Date：2025-04-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 47-52 )