Safety and efficacy of a novel three-dimensional magnetic resonance imaging model for uterine incision in placenta previa

Objective: To assess a novel three-dimensional (3D) magnetic resonance imaging (MRI) model for determining position of uterine incision during cesarean delivery among patients with placenta previa. Methods: A prospective study was conducted among women with singleton pregnancies complicated by placenta previa who delivered by cesarean at a hospital in China between January 1, 2014, and January 1, 2016. Patients chose whether to undergo 3D MRI modeling to guide uterine incision (study group) or the standard intervention (control group). Medical records were reviewed to collect data on maternal, neonatal, and operative characteristics. Results: Among 134 women enrolled, 45 were in the study group and 89 in the control group. When compared with the control group, patients in the study group experienced less intraoperative blood loss (678.65649.54 vs 933.96695.25mL; P=0.042) and shorter operative times (65.13 +/- 27.38 vs 86.88 +/- 54.43minutes; P=0.013). Fewer patients in the study group received transfusions (11 [24%] vs 38 [43%]; P=0.038). No between-group differences were found for hysterectomy rate, hospitalization days and cost, or neonatal outcomes. Conclusion: Uterine incision guided by a 3D MRI model could improve maternal outcomes during cesarean delivery, including reductions in intraoperative blood loss, transfusion frequency, and operative time.