Correlation of placental thickness and PAS disorders: findings from MRI

Lü, Tao; Wang, Yishuang; Guo, Aiwen; Deng, Yan; Wu, Chengqian; Li, Xiangqi; Liu, Siyun

doi:10.1007/s00261-022-03420-9

Cited by 7 publications

(3 citation statements)

References 17 publications

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“…However, when US findings are equivocal, MRI is the second-line diagnostic tool to evaluate PAS disorders. Dark intraplacental bands on T2WI, increased placental thickness, placental/uterine bulge, myometrial thinning, bladder wall interruption, focal exophytic mass, and abnormal vascularization of the placental bed are the main MRI findings suggestive of a PAS disorder [80][81][82] (Figure 9). Antenatal recognition of PAS disorders is crucial for optimizing management strategies, which may include planned cesarean delivery, pre-operative endovascular interventions, and coordination with a multidisciplinary team to mitigate the risk of severe bleeding and associated maternal morbidity [57,83].…”

Section: Placental Disordersmentioning

confidence: 99%

Abnormal Uterine Bleeding: A Pictorial Review on Differential Diagnosis and Not-So-Common Cases of Interventional Radiology Management

Viganò,

Smedile,

Cazzella

et al. 2024

Diagnostics

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Abnormal uterine bleeding (AUB) poses a multifaceted challenge in women’s health, necessitating an integrated approach that addresses its diverse etiologies and clinical presentations. The International Federation of Gynecology and Obstetrics PALM-COEIN classification system provides a systematic approach to the diagnosis of AUB in non-pregnant women, based on clinical and imaging-based categorization of causes into structural (Polyps, Adenomyosis, Leiomyomas and Malignancy; PALM), and non-structural causes (Coagulopathies, Ovulatory disorders, primary Endometrial disorders, Iatrogenic and Not otherwise classified; COEIN). On the other hand, placental disorders, uterine rupture, ectopic pregnancy and retained products of conceptions are the main causes of uterine bleeding during pregnancy and in the peripartum period. Ultrasound is usually the first-line imaging technique for the differential diagnosis of causes of AUB. Computed Tomography may be useful if ultrasound findings are unclear, especially in emergency settings. Magnetic resonance imaging, when indicated, is an excellent second-line diagnostic tool for a better non-invasive characterization of the underlying cause of AUB. This pictorial review aims to illustrate the main causes of AUB from the point of view of diagnostic imaging and to show not-so-common cases that can be treated by means of interventional radiology.

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Section: Placental Disordersmentioning

confidence: 99%

Abnormal Uterine Bleeding: A Pictorial Review on Differential Diagnosis and Not-So-Common Cases of Interventional Radiology Management

Viganò,

Smedile,

Cazzella

et al. 2024

Diagnostics

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“…al found that as the depth of placental invasion decreases, clinical risk factors and sonographic evaluation are less reliable in the antenatal prediction of PAS [27]. Increased placental thickness and presence of a "placental bulge", landmarks potentially easier to visualize on MRI, are also suggestive of PAS severity [28,29]. The potential for unanticipated morbidity underscores the need for improved diagnostic tools for PAS.…”

Section: Principal Ndingsmentioning

confidence: 99%

Abnormal placentation: the necessity for preoperative magnetic resonance imaging

Huang

Knickerbocker

Pon

et al. 2022

Preprint

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Background:Placenta accreta spectrum (PAS) is characterized by abnormal placental adherence that increases the risk of maternal hemorrhage and death. Current literature suggests lower rates of maternal morbidity and mortality when placenta accreta spectrum is diagnosed or suspected prenatally. We examined the use of preoperative imaging in predicting PAS with the goal of assessing concordance between imaging modalities and impact of differential imaging on morbidity. Methods: Women with suspected placenta accreta spectrum who delivered at our institution from 2010-2018 were included. Perioperative diagnoses, imaging, and pathology reports were abstracted from medical records. Descriptive statistics, ANOVA, chi square, multinomial logistic regression, Cohen’s kappa analyses were performed. Results: There were 152 cases with suspected placenta accreta spectrum from 2010-2018 with 131 (86.2%) cases confirmed by final pathology. Of the confirmed cases, there were 38 (25%) accretas, 62 (40.8%) incretas, and 31 (20.4%) percretas. Magnetic resonance imaging (MRI) more accurately diagnosed placenta accreta spectrum (39% of cases) than ultrasound (25%). Cohen’s kappa for ultrasound versus pathology was 0.02836, demonstrating slight inter-rater agreement (p=0.55) than 0.5087 in the MRI versus pathology group (p=0.08). Of the 107 patients requiring resuscitative blood products, indicators of morbidity, the percreta group had significantly greater mean estimated blood loss (4.8L) with longer mean length of hospital stay (p=0.014) compared to increta (3.1L) and accreta (2.6L) (p=0.04). Conclusions: This study supports the role of pelvic magnetic resonance imaging for antepartum diagnosis of placenta accreta spectrum. Accurate diagnosis is essential for the perioperative coordination of care to improve maternal outcomes and reduce mortality.

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“…The size of the placenta is an indicator offetal health and development.Placental thickness (PT) is an additional ultrasonographic parameter often employed to assess the placenta [1].…”

Section: Introductionmentioning

confidence: 99%

Ultrasonographic Measurement of Placental Thickness and Its Correlation with Estimated Fetal Weight

I.Azab,

M.El-Gazzar,

A.Abdel Hameed

et al. 2023

Benha Journal of Applied Sciences

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Background: Placenta is a materno-fetal organ, and its size is indicative of the fetus health and growth. Placental thickness (PT) is an additional ultrasonographic metric commonly used to evaluate the placenta.The objectiveof this study was to assess the relationship between PT (at 32-and 36-weeks of gestation) and to estimate the fetal weight. Methods: This observational study was performed at the Department of Obstetrics andGynecologyBenha University Hospital and ShebeenElkoom insurance hospital over a period from July 2020 to November 2021.Results: There was a significant positive correlation between PTat 32weeks and Apgar score at 1st and 5th min. Also, there was a significant positive correlation between PTat 36 weeks and Apgar score at 1st and 5th min. There was a significant positive correlation between PT at 32 weeks, PT 36 at weeks and femur length(FL), abdominal circumference (AC), biparietal diameter (BPD), head circumference (HC), estimated fetal weight (EFW) and amniotic fluid index (AFI). Conclusion: The evaluation of fetal weight( a vital element of prenatal treatment), relies heavily on ultrasonography(US).PT measured at the umbilical cord insertion point is a reliable sonographic indication for fetal weight evaluation, due to their linear correlation .

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Correlation of placental thickness and PAS disorders: findings from MRI

Cited by 7 publications

References 17 publications

Abnormal Uterine Bleeding: A Pictorial Review on Differential Diagnosis and Not-So-Common Cases of Interventional Radiology Management

Abnormal Uterine Bleeding: A Pictorial Review on Differential Diagnosis and Not-So-Common Cases of Interventional Radiology Management

Abnormal placentation: the necessity for preoperative magnetic resonance imaging

Ultrasonographic Measurement of Placental Thickness and Its Correlation with Estimated Fetal Weight

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