Evidence map›Paper›PMID 39833725›Full record

ArticleBMC pregnancy and childbirth2025

Preoperative ultrasound risk factors for peripartum hysterectomy among PAS suspected pregnancies.

Lulu Wang, Tianjiao Liu, Yang Yang, Yalan Li, Li Xiao, Xin Li, Sumei Wei

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC pregnancy and childbirth, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Lulu Wang *Department of Obstetrics, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, No.1617, Riyue Avenue, Chengdu, Sichuan, 610091, China.
Tianjiao Liu *Department of Gynecology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
Yang Yang *Department of Obstetrics, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, No.1617, Riyue Avenue, Chengdu, Sichuan, 610091, China.
Yalan LiPsychosomatic Medical Center, The Fourth People's Hospital of Chengdu, Chengdu, China.
Li XiaoMedical Administrative Department, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, No.1617, Riyue Avenue, Chengdu, Sichuan, 610091, China. 250129266@qq.com.
Xin LiDepartment of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, 20, 3Rd Section, Renmin S. Rd, Chengdu, 610041, China. xinlicwcch@163.com.
Sumei WeiDepartment of Obstetrics, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, No.1617, Riyue Avenue, Chengdu, Sichuan, 610091, China. weisumeicwcch@aliyun.com.

Funding

Japan-China Sasakawa Medical Fellowship Program 4408Tianfu Jincheng Laboratory Foundation TFJC2023010001Yingcai Scheme, Chengdu Women's and Children's Central Hospital YC2023004
6 · The paper itself

Abstract

objectiveThis study aimed to identify risk factors for peripartum hysterectomy among pregnancies complicated by suspected Placenta Accreta Spectrum (PAS) in preoperative obstetric imaging screening.

methodsData were retrospectively extracted from the Longitudinal Placenta Accreta Spectrum Study (LoPASS), covering pregnancies with PAS from January 2018 to March 2023 at our institute. Patients were divided into Control and Hysterectomy groups based on whether they underwent hysterectomy. Sociodemographic, obstetric, and clinical characteristics were compared between the groups. Multivariate logistic regression analysis was performed on the characteristics with statistical significance to explore risk factors for peripartum hysterectomy.

resultsAmong 523 pregnancies with suspected PAS, 20 underwent hysterectomy. The Hysterectomy group had a significantly higher mean age (34.50 ± 5.05 vs. 31.66 ± 4.43 years, p = 0.005) and pre-pregnancy BMI (26.35 ± 3.27 vs. 23.84 ± 3.99, p = 0.006). The Hysterectomy group also had a higher proportion of patients with more than 2 gravidities (100% vs. 61.6%, p = 0.022) and multiple parities (90.0% vs. 39.9%, p < 0.001). Higher percentages of placenta percreta (90.0% vs. 28.2%, p < 0.001), placenta attaching to the anterior uterine wall (57.9% vs. 31.8%, p = 0.033), and higher PAS ultrasonographic scores (11.78 ± 2.68 vs. 6.79 ± 2.77, p < 0.001) were observed in the Hysterectomy group. Perioperative outcomes revealed significantly longer surgical durations (171.90 ± 49.27 vs. 53.46 ± 24.41 min, p < 0.001) and higher rates of preterm birth (100.0% vs. 55.3%, p < 0.001). Intraoperative blood loss was also substantially greater in the Hysterectomy group (2695.00 ± 1241.17 ml vs. 764.31 ± 385.10 ml, p < 0.001). Variables significantly associated with increased peripartum hysterectomy risk included prior cesarean sections (OR = 1.44, p = 0.048), placenta attaching to the anterior uterine wall (OR = 0.73, p = 0.015), placenta completely covering the uterine incision (OR = 1.27, p = 0.035), gestational hypertensive disorder (OR = 1.69, p = 0.042), placenta percreta (OR = 2.31, p = 0.032), and PAS ultrasonographic score higher than 10 (OR = 2.71, p = 0.008).

conclusionMost of ultrasound PAS scoring subitems were significantly higher in Hysterectomy group. Cesarean deliveries, placental positioning on the anterior uterine wall, GHD, types of PAS, and ultrasound PAS score higher than 10 predicts peripartum hysterectomy, highlighting the importance of early, timely, and consistent monitoring of the placenta using obstetric ultrasound in pregnancies with suspected PAS.

trial registrationChiCTR2100052428, October 26th, 2021.

Indexed as

HysterectomyPlacenta AccretaUltrasonography, PrenatalAdultCesarean SectionFemaleHumansPeripartum PeriodPregnancyRetrospective StudiesRisk FactorsCesarean sectionsHysterectomyPeripartum hemorrhagic morbidityPlacenta accreta spectrumRisk factors

Identifiers

PMID39833725
PMCPMC11748833

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.