Background: The purpose of this study was to develop a model to predict
cesarean hysterectomy accompanying cesarean section in patients with placenta
previa. Methods: We retrospectively reviewed 926 patients diagnosed with
placenta previa who had cesarean section from January 2011 to December 2021. We
analyzed data by independent t-test and Pearson’s chi-squared test. Multivariate
logistic regression analysis was used to develop a predictive model and identify
factors predictive for cesarean hysterectomy accompanying cesarean section.
Results: A total of 44 cesarean hysterectomies (4.8%) were performed in
926 patients with placenta previa. History of cesarean section (1 (odds ratio
(OR) 13.57, 95% confidence interval (CI) 4.29–42.96), 2 (OR 83.28, 95%
CI 21.98–315.55)), anterior placenta (OR 3.06, 95% CI 1.22–7.68), adherent
placenta (OR 8.78, 95% CI 3.65–21.09), presence of lacuna (OR 3.74, 95% CI
1.55–9.04), and old maternal age (40 years (OR 4.65, 95% CI
1.60–13.49)) were factors selected to develop a model to predict cesarean
hysterectomy. Based on this model, an equation was developed and tested for
performance. This model using five factors yielded an area under the curve of
0.951 (95% CI 0.921–0.981) to predict the probability of cesarean hysterectomy
accompanying cesarean section. Conclusions: Application of this
predictive model may provide an effective prediction of cesarean hysterectomy in
patients with placenta previa. Adequate pre-operative preparation and
intraoperative strategies can be indicated based on this model.
