A proposal for standardized magnetic resonance imaging (MRI) descriptors of abnormally invasive placenta (AIP) – From the International Society for AIP

Morel, Olivier; Collins, Sally; Uzan-Augui, J.; Masselli, Gabriele; Duan, Jun; Chabot‐Lecoanet, A.; Braun, Thorsten; Langhoff‐Roos, Jens; Soyer, Philippe; Chantraine, Frédéric

doi:10.1016/j.diii.2019.02.004

Cited by 38 publications

(37 citation statements)

References 46 publications

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“…Therefore, to facilitate international collaboration and comparison among studies, a standardized definition of the MRI descriptors of PAS has been recently proposed by the International Society for Placenta Accreta Spectrum (www.is-pas.org; formerly the EW-AIP). 49…”

Section: Mri Diagnosismentioning

confidence: 99%

<p>Placenta Accreta Spectrum Disorders: Challenges, Risks, and Management Strategies</p>

Morlando¹,

Collins²

2020

IJWH

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The worldwide incidence of placenta accreta spectrum (PAS) is rapidly increasing, following the trend of rising cesarean delivery. PAS is an heterogeneous condition associated with a high maternal morbidity and mortality rate, presenting unique challenges in its diagnosis and management. So far, the rarity of this condition, together with the absence of high quality evidence and the lack of a standardized approach in reporting PAS cases for the ultrasound, clinical, and pathologic diagnosis, represented the main challenges for a deep understanding of this condition. The study of the available management strategies of PAS has been hampered by the heterogeneity of the available epidemiological data on this condition. The aim of this review is to provide a critical view of the current available evidence on the screening, the diagnosis, and the management options for PAS disorders, with a special focus on the challenges we foresee for the near future.

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Section: Mri Diagnosismentioning

confidence: 99%

<p>Placenta Accreta Spectrum Disorders: Challenges, Risks, and Management Strategies</p>

Morlando¹,

Collins²

2020

IJWH

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“…9 MRI descriptors were heterogeneous placenta placental bulge, dark intra placental bands, placental infarction, loss retroplacental dark zone, myometrial thinning, bladder wall interruption and abnormal vascularization placental bed. 8 Statistical analysis was performed with Stata version 13.0 (Stata Corporation). The rates of occurrence of each US & MRI descriptor were reported and compared between both Groups with a Chi 2 or Fisher's exact test, as appropriate.…”

Section: Materials and Me Thodsmentioning

confidence: 99%

Performance of antenatal imaging to predict placenta accreta spectrum degree of severity

Morel

Beekhuizen

Braun

et al. 2021

Acta Obstet Gynecol Scand

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Introduction In cases of placenta accreta spectrum, a precise antenatal diagnosis of the suspected degree of invasion is essential for the planning of individual management strategies at delivery. The aim of this work was to evaluate the respective performances of ultrasonography and magnetic resonance imaging for the antenatal assessment of the severity of placenta accreta spectrum disorders included in the database. The secondary objective was to identify descriptors related to the severity of placenta accreta spectrum disorders. Material and methods All the cases included in the database for which antenatal imaging data were available were analyzed. The rates of occurrence of each ultrasound and magnetic resonance imaging descriptor were reported and compared between the Group “Accreta‐Increta” (FIGO grades 1 & 2) and the Group “Percreta” (FIGO grade 3). Results Antenatal imaging data were available for 347 women (347/442, 78.5%), of which 105 were included in the Group “Accreta – Increta” (105/347, 30.2%) and 213 (213/347, 61.4%) in the Group “Percreta”. Magnetic resonance imaging was performed in addition to ultrasound in 135 women (135/347, 38.9%). After adjustment for all ultrasound descriptors in multivariate analysis, only the presence of a bladder wall interruption was associated with a significant higher risk of percreta (Odds ratio 3.23, Confidence interval 1.33–7.79). No magnetic resonance imaging sign was significantly correlated with the degree of severity. Conclusions The performance of ultrasound and magnetic resonance imaging to discriminate mild from severe placenta accreta spectrum disorders is very poor. To date, the benefit of additional magnetic resonance imaging has not been demonstrated.

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“…The term "pathologically invasive (attached) placenta" describes a placenta that is not naturally separated after the birth of a child and cannot be separated without abnorml blood loss [11]. The range of placental attachment disorders is a multifactorial process that encompasses a heterogeneous group of conditions characterized by pathological invasion of trophoblast tissue into the myometrium and the serous membrane of the uterus [1].…”

Section: Review and Discussionmentioning

confidence: 99%

“…Magnetic resonance imaging (MRI) is gaining importance in the differential diagnosis of various types of abnormal placental invasion. The method helps to determine the location, level, depth and blood flow in the area of invasion, with maternal obesity and posterior placentation, in doubtful cases, based on the results of ultrasound [11,27]. To date, the main significant markers of MRI have been identified.…”

Section: Review and Discussionmentioning

confidence: 99%

Current State of the Problem Ofabnormal Invasion of the Placenta in Obstetrics

et al. 2020

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The aim: On the basis of literature data, as well as a clinical case study, to assess the state of the problem of abnormal invasion of the placenta in obstetrics at the present stage. Materials and methods: Based on the materials of the world’s leading citation databases (MEDLINE, EMBASE, Cochrane), a brief review of the literature data over the past 5 years is presented, dedicated to the issues of abnormal placental invasion. The possibilities of a complex of diagnostic studies and clinical management of women with an anomaly of placenta attachment are considered. A clinical case study of abnormal placental invasion is presented. Conclusions: AIP is an extremely serious condition with not fully understood etiological and pathogenic mechanisms. Correct and timely verification of this pathological condition, based on the simultaneous use of a whole complex of diagnostic studies (history taking, 2D, 3D, energy and color Doppler mapping, MRI), contributes to the development of individual tactics for the management and delivery in women with AIP, making it possible to reduce maternal morbidity and mortality and improve perinatal outcomes.

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A proposal for standardized magnetic resonance imaging (MRI) descriptors of abnormally invasive placenta (AIP) – From the International Society for AIP

Cited by 38 publications

References 46 publications

<p>Placenta Accreta Spectrum Disorders: Challenges, Risks, and Management Strategies</p>

<p>Placenta Accreta Spectrum Disorders: Challenges, Risks, and Management Strategies</p>

Performance of antenatal imaging to predict placenta accreta spectrum degree of severity

Current State of the Problem Ofabnormal Invasion of the Placenta in Obstetrics

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