OP30.03: Screening for placenta accreta by ultrasound in the first trimester

Stirnemann, J.; Forner, S.; Bernard, Jean‐Pierre; Ville, Y.

doi:10.1002/uog.8208

Cited by 1 publication

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“…All these considerations have led to calls for first trimester ultrasound screening. 7 First trimester diagnosis remains rare, usually following unexpected massive haemorrhage during pregnancy termination or evacuation of retained products of conception. 8 In some cases, heavy genital tract bleeding occurs weeks or months after evacuation of a spontaneous, missed or incomplete miscarriage, with the diagnosis of AIP after histological examination.…”

Section: Introductionmentioning

confidence: 99%

First trimester maternal serum biochemical markers of aneuploidy in pregnancies with abnormally invasive placentation

Thompson

Otigbah

Nnochiri

et al. 2015

BJOG

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Objective To examine whether differences exist in routine first trimester maternal serum screening analyte measurements between normal pregnancies, placenta praevia and abnormally invasive placentation (AIP). Design Multidisciplinary audit.Setting Associated university teaching hospital with 9000 annual deliveries.Population Five hundred and sixteen pregnancies in total, including 344 normal controls, 17 with AIP and 155 placenta praevia cases.Methods Comparison of maternal serum free bhCG and PAPP-A MoMs distribution in pregnancies with abnormally invasive placentation, placenta praevia and normal controls, after correcting for known confounding factors between October 2005 and September 2013. Data from a previously published first trimester AIP and biochemistry study were combined with our study data and compared in the above way to complete the analysis.Main outcome measures Differences in first trimester maternal serum PAPP-A and free bhCG in AIP, placenta praevia, and normal pregnancies.Results Median free bhCG MoM in the control group was 1.04, and 1.08 (P = 0.859) in the placenta praevia group compared with 0.81 in the AIP group (P = 0.06). Median PAPP-A MoM was 1.01 in the control group and 1.05 (P = 0.83) in praevia, compared with 1.22 in AIP cases (0.16). The combined AIP dataset gave an overall PAPP-A median MoM of 1.40, and free bhCG of 0.85. Both markers showed a significantly different distribution from controls (PAPP-A P = 0.002 and free bhCG P = 0.031).Conclusions There may be differences between first trimester maternal serum biochemical markers between normal pregnancies and those complicated by abnormally invasive placentation. If upheld, this may provide useful information for the early identification of abnormally invasive placentation. More studies are required.

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Section: Introductionmentioning

confidence: 99%