{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T14:35:24Z","timestamp":1788878124948,"version":"build-2803163510"},"reference-count":45,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2022,10,14]],"date-time":"2022-10-14T00:00:00Z","timestamp":1665705600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"\n Objective<\/jats:title>\n To evaluate certain two-dimensional (2D) ultrasound signs as predictors of massive peri-operative blood loss (PBL) in pregnant women with placenta previa suspicious of PAS disorder.<\/jats:p>\n <\/jats:sec>\n \n Materials and methods<\/jats:title>\n A single center retrospective study was done in pregnant women who had undergone prenatal diagnosis with 2D ultrasound grey scale and color Doppler using the EW-AIP (which has been changed to IS-PAS (International Society for the Placenta Accreta Spectrum)) criteria between January 2007 and May 2021. The patients were divided into 2 groups, non-massive hemorrhage with PBL \u2264 2500 mL and massive PBL >2500 mL. All PAS cases had pathological confirmation. Ultrasound signs and hemorrhagic outcomes were compared between the two groups. A PAS scoring system to predict massive PBL was constructed and a receiver operating characteristic (ROC) curve was calculated to evaluate the efficacy of the scoring system.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Of 534 women, 146 (28.3%) had PBL > 2500 mL and 388 (71.7%) had PBL \u2264 2500 mL. In the massive PBL group, 101 (69.2%) were diagnosed as PAS and 45 (30.8%) as placenta previa alone. From 10 evaluated 2D ultrasound signs, 3 had the highest odds ratios (ORs) associated with massive PBL, \u2018focal exophytic mass\u2019 OR 8.17 (\n p<\/jats:italic>\n = 0.024), \u2018placental bulge\u2019 OR 2.47 (\n p<\/jats:italic>\n = 0.011), and \u2018placental lacunae feeder vessels\u2019 OR 2.38 (\n p<\/jats:italic>\n = 0.01). When using the PAS scoring system, the AUC to predict massive PBL was 0.80 (95% CI, 0.76\u20130.85,).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Our PAS scoring system based on 2-dimensional ultrasound signs combined with grey scale and color Doppler is useful to predict massive PBL and can help optimize pre-operative management in cases of previa suspicious of PAS.<\/jats:p>\n <\/jats:sec>","DOI":"10.1371\/journal.pone.0276153","type":"journal-article","created":{"date-parts":[[2022,10,14]],"date-time":"2022-10-14T13:56:01Z","timestamp":1665755761000},"page":"e0276153","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":13,"title":["Two-dimensional ultrasound signs as predictive markers of massive peri-operative blood loss in placenta previa suspicious for placenta accreta spectrum (PAS) disorder"],"prefix":"10.1371","volume":"17","author":[{"given":"Wattanan","family":"Watthanasathitnukun","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8056-2617","authenticated-orcid":true,"given":"Savitree","family":"Pranpanus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chusana","family":"Petpichetchian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,10,14]]},"reference":[{"key":"pone.0276153.ref001","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1016\/j.placenta.2011.11.010","article-title":"Placenta accreta: pathogenesis of a 20th century iatrogenic uterine disease","volume":"33","author":"E Jauniaux","year":"2012","journal-title":"Placenta"},{"key":"pone.0276153.ref002","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1002\/ijgo.12409","article-title":"FIGO consensus guidelines on placenta accreta spectrum disorders: Nonconservative surgical management","volume":"140","author":"L Allen","year":"2018","journal-title":"Int J Gynaecol Obstet"},{"key":"pone.0276153.ref003","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1002\/ijgo.12410","article-title":"FIGO consensus guidelines on placenta accreta spectrum disorders: Conservative management","volume":"140","author":"L Sentilhes","year":"2018","journal-title":"Int J Gynaecol Obstet"},{"key":"pone.0276153.ref004","doi-asserted-by":"crossref","first-page":"1033","DOI":"10.2147\/IJWH.S224191","article-title":"Placenta Accreta Spectrum Disorders: Challenges, Risks, and Management Strategies","volume":"12","author":"M Morlando","year":"2020","journal-title":"Int J Womens Health"},{"key":"pone.0276153.ref005","doi-asserted-by":"crossref","first-page":"1458","DOI":"10.1016\/j.ajog.2004.12.074","article-title":"Abnormal placentation: twenty-year analysis","volume":"192","author":"S Wu","year":"2005","journal-title":"Am J Obstet Gynecol"},{"key":"pone.0276153.ref006","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1002\/ijgo.12406","article-title":"FIGO consensus guidelines on placenta accreta spectrum disorders","volume":"140","author":"E Jauniaux","year":"2018","journal-title":"Introduction. 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