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A novel scoring model to predict massive hemorrhage during dilatation and curettage following focused ultrasound ablation surgery in patients with type 2 cesarean scar pregnancy

Year: 2025

Type: article

Abstract: OBJECTIVE: To develop a predictive model for assessing massive hemorrhage risk during dilatation and curettage (D&C) after focused ultrasound ablation surgery (FUAS) in Type 2 cesarean scar pregnancy (CSP) patients. METHODS: A retrospective analysis of 405 Type 2 CSP patients treated at Hunan Maternal and Child Health Hospital (2018-2023) was conducted. Multivariable logistic regression identified independent risk factors, and a nomogram was constructed. Model performance was evaluated using AUC, calibration curves, and decision curve analysis (DCA). Ten-fold cross-validation was performed, and external validation was conducted on 327 patients. RESULTS: < 0.001). C-scar thickness and HCG levels were also included in the model as clinically significant factors. The model showed high discriminative ability (AUC 0.910, 95% CI: 0.867-0.953) and was validated through 10-fold cross-validation (mean AUC 0.838). External validation confirmed its robustness (AUC 0.812, 95% CI: 0.742-0.881). Calibration curves and DCA confirmed its accuracy and clinical utility. CONCLUSION: The predictive model effectively assesses hemorrhage risk in Type 2 CSP patients post-FUAS, offering valuable clinical utility.

Source: International Journal of Hyperthermia

DOI: 10.1080/02656736.2025.2495362