Diagnosis of abnormally invasive posterior placentation: the role of MR imaging

Kocher, Madison; Sheafor, Douglas H.; Bruner, Evelyn; Newman, Charles N.; Nino, Julio Fernando Mateus

doi:10.1016/j.radcr.2017.01.014

Cited by 13 publications

(8 citation statements)

References 12 publications

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“…For the final diagnosis of placenta accreta, the results are heterogenous with correct and concordant US and MRI findings in only three of 15 (20.0%) cases. The limited value of MRI in diagnosing the correct form of PAS was also shown in a study by Einerson et al 28 However, MRI is particularly valuable in cases of a posterior placenta 11 and might provide valuable information when planning surgery 29,30 …”

Section: Discussionmentioning

confidence: 86%

“…The limited value of MRI in diagnosing the correct form of PAS was also shown in a study by Einerson et al 28 However, MRI is particularly valuable in cases of a posterior placenta 11 and might provide valuable information when planning surgery. 29,30 The strength of our study was that data were derived from prospective US examinations evaluating standardized US criteria by experienced examiners in a routine screening combining the US data and delivery outcomes with a high percentage of PAS cases that had histological examination. It is also one of the first studies to separately examine the performance of milder and severe forms of PAS.…”

Section: Positive Greyscale Parameters Positive Colormentioning

confidence: 99%

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Accuracy of ultrasound for the detection of placenta accreta spectrum in a universal screening population

Baumann

Pawlik

Hoesli

et al. 2022

Intl J Gynecology & Obste

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Objectives The current study aimed to determine the sensitivity and specificity of ultrasound for the diagnosis of placenta accreta spectrum (PAS) in a universal screening population and assesses the added value of magnetic resonance imaging (MRI). Methods This retrospective analysis evaluated 5219 patients with singleton pregnancies who had a standardized ultrasound (US) examination in our unit and delivered at our institution between 2014 and 2019. Results A total of 181 (3.5%) of 5219 (100%) patients had a suspicion or diagnosis of PAS with US. The accuracy of US in detecting placenta increta/percreta showed a sensitivity of 100%, specificity of 99.9%, positive predictive value of 82.4%, and a negative predictive value of 100%. The diagnosis of all forms of PAS showed a sensitivity of 25.8%, specificity of 99.8%, positive predictive value of 80.8%, and a negative predictive value of 97.7%. MRI was concordant with US in 11 of 14 (78.5%) cases of severe forms of PAS and in three of 15 (20.0%) cases with placenta accreta. Conclusion A standardized US evaluation can be applied in a universal screening setting for the diagnosis of severe forms of PAS. MRI is a complementary examination in severe forms of PAS but seems of limited value to discriminate placenta accreta from placenta increta/percreta.

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Section: Discussionmentioning

confidence: 86%

Section: Positive Greyscale Parameters Positive Colormentioning

confidence: 99%

Accuracy of ultrasound for the detection of placenta accreta spectrum in a universal screening population

Baumann

Pawlik

Hoesli

et al. 2022

Intl J Gynecology & Obste

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“…[26] Ancak posterior yerleşimli plasenta varlığında ve obez hastalarda ultrasonun rezolüsyonu iyi olmadığından MRG, ultrasona yardımcı tanı yöntemi olarak kullanılabilir. [27] Çalışmamızda incelenen olguların hiçbirinde, plasental invazyon anomalilerin tanısında MRG kullanılmamıştır. Bunun nedeni, plasenta insersiyon anomalilerinin ultrasonografi ile tespit edilebilmiş olmasıdır.…”

Section: Discussionunclassified

Plasenta Previa Olgularının Retrospektif Değerlendirilmesi

İşgüder¹,

Gülücü

Bulut³

et al. 2020

Journal of Contemporary Medicine

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Bu çalışmada, plasenta previa (PP) olgularında maternal sosyodemografik özelliklerin, obstetrik risk faktörlerin ve perinatal sonuçların değerlendirilmesini amaçladık. Gereç ve Yöntem: Çalışmada Ocak 2013Kasım 2017 tarihleri arasında kliniğimizde takip edilen 71 PP olgusu retrospektif olarak incelendi. Olguların obstetrik öyküleri, prepartum ve postpartum hemoglobin değerleri, kan transfüzyon ihtiyacı, 1. ve 5. dakika apgar skorları, kanama kontrolünü sağlamak amacıyla yapılan cerrahi manevralar, plasental invazyon bulgusu, intrauterin ölü fetus ve neonatal ölüm gibi komplikasyonlar incelendi. Bulgular: Değerlendirilen 71 PP olgusunun %19,7 (n=14)'sini nullipar kadınlar oluştururken, %22,5 (n=16)'ini daha önce 1 kez, %42,3 (n=30)'ünü 2 kez, %15,5 (n=11)'ini üç veya daha fazla sayıda doğum yapmış kadınlar oluşturuyordu. Olguların %53,5 (n=38)'inin önceden sezaryen öyküsü yoktu, %45 (n=32)'inin geçirilmiş 1 ve 2 sezaryen öyküsü, %1,5 (n=1)'ünün üç sezaryen öyküsü vardı. Ortalama bebek doğum ağırlığı 2749.79±777.38 gr (980 gr-4680 gr), 1. ve 5. dakika apgar skorları sırası ile 7.31±1.39 ve 8.24±1.33 olarak tespit edildi. İnvazyon bulguları nedeniyle 9 olguya peripartum histerektomi uygulandı. On üç olguya perioperatif, sekiz olguya postoperatif kan transfüzyonu yapıldı. Sonuç: PP, hem erken doğum ve buna bağlı yenidoğan sorunları hem de plasental invazyon anomalileri ve maternal kanama nedeni ile günümüzde neonatal ve maternal morbidite ve mortalitenin önemli nedenleri arasındadır. Optimal sonuç elde edebilmek için PP'den şüphelenildiğinde ve antenatal dönemde tanı konulduğunda peripartum histerektomi ve uterin devaskülarizasyon manevraları konusunda tecrübeli ve oluşabilecek komplikasyonlara müdahale edebilecek deneyimli cerrahların bulunduğu ve kan ürünlerinin temin edilebileceği üçüncü basamak merkezlerde operasyonların yapılmasında fayda vardır.

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“…The increasing ratio of obstetric complication such as abnormal placentation has raised the percentage of cesarean section deliveries. The placenta abnormally lies at the lower segment of uterine in a condition named as placenta previa 1 . The abnormal attachment of the uterus to the placenta is the main cause of development of abnormal placentation.…”

Section: Introductionmentioning

confidence: 99%

Role of MRI in Detecting Abnormal Placentation in Patients with Strong Ultrasound Concern for Myometrial Invasion

Afridi¹,

Orakzai²,

Yasmeen³

et al. 2022

PJMHS

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Abnormal placentation has raised the ratio of cesarean cases. In such obstetric complication the placenta lie at the lower segment of the uterus. These abnormal attachments of placenta to uterus and invasion to adjacent organs are the main cause of placenta previa. These are not only raising delivery challenges but also raising the mortality cases. Objective: For evaluation of the diagnostic efficacy of MRI to locate placentation abnormalities with high accuracy and sensitivity. This not only helps in preoperative delivery planning but also decreases the ratio of mortality. Study Setting: It was an observational study, conducted at radiology department of Mardan Medical Complex Mardan for the duration of six months from September 2021 to February 2022. Methods: The women suspicion of placentation abnormalities were recommended with MRI. The consecutive 185 pregnant women were included in the study. The results obtained from MRI were compared with the results obtained by C-section. Cesarean section results were considered as standard. The treatment strategy was decided in accordance with the MRI findings. The treatment strategies which opt during the CS were compared with the strategy created on the basis of MRI. Results: 115 women were diagnosed with abnormal placentation. The 70 women out of 185 were diagnosed with placenta previa. The percentage false results were seen in 18 patients. The false negative results of MRI were seen in three patients. After comparison between the findings of MRI and CS the sensitivity, positive predictive values and other parameters were calculated. The sensitivity was 97%, while the positive predictive value was 84%. The other parameters such as specificity were 79% and negative predictive value was 95%. The sensitivity, accuracy, and positive predictive values of the planning strategy created for treatment on the basis of MRI findings were calculated. There was significant correlation between the findings of MRI and CS. Conclusion: For the future planning of treatment strategy for the women suspected of abnormal placentation, MRI is highly suggested diagnostic tool with better efficacy and sensitivity. This imaging modality helps in proper and accurate diagnosis of abnormal placentation. Keywords: Abnormal placentation, obstetric complications, treatment strategy, placenta previa.

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Diagnosis of abnormally invasive posterior placentation: the role of MR imaging

Cited by 13 publications

References 12 publications

Accuracy of ultrasound for the detection of placenta accreta spectrum in a universal screening population

Accuracy of ultrasound for the detection of placenta accreta spectrum in a universal screening population

Plasenta Previa Olgularının Retrospektif Değerlendirilmesi

Role of MRI in Detecting Abnormal Placentation in Patients with Strong Ultrasound Concern for Myometrial Invasion

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