Outcomes of Prospectively Collected Consecutive Cases of Antenatal-suspected Placenta Accreta

Weiniger, Carolyn F.; Einav, Sharon; Deutsch, Lisa; Ginosar, Yehuda; Ezra, Yacov; Eid, Luminita

doi:10.1097/01.aoa.0000455592.19728.03

Cited by 10 publications

(21 citation statements)

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“…There were 22 retrospective studies 14, and seven prospective. 19, [47][48][49][50][51][52] Twenty-eight (28/29) were published after the year 2000 (Table 1). There were 18 studies from a single institution 14,[26][27][28][29][30][31]33,[36][37][38][39][40]42,44 , three involving two affiliated institutions 32,34,51 , two studies from the National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network 48,50 , two regional studies 43,46 , three national studies 41,45,49 and two international studies involving four 19 and two 52 countries, respectively.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…The clinical criteria described by the authors for the clinical diagnosis of placenta accreta spectrum at delivery felt into three categories (Table 2): basic description 32,34,35,[38][39][40]44,47,48,50,51 ; extended description 27,30,33 ; and World Health Organization (WHO) international classification. 19,36,43,46 More than a third of the studies (11/29) 14,26,29,31,37,41,42,45,49,52 did not describe the clinical criteria used for the diagnosis of placenta accreta spectrum at birth.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…5,8 Prenatal diagnosis has been shown to decrease maternal morbidity and has thus become crucial in improving the management of placenta accreta spectrum. [9][10][11] Recent retrospective cohort studies from the US have also shown that women managed by a multidisciplinary team in centre of excellence were less likely to require emergency surgery, large-volume blood transfusions and reoperation within a week of delivery compared with women managed by standard obstetric care without a specific protocol. [12][13][14][15][16] Access to specialist centres, to blood products for transfusion and neonatal and maternal intensive care is variable in many high-income countries and often limited or non-existent in most middle-and low-income countries.…”

Section: Introductionmentioning

confidence: 99%

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Prevalence and main outcomes of placenta accreta spectrum: a systematic review and meta-analysis

Jauniaux

Bunce

Grønbeck

et al. 2019

American Journal of Obstetrics and Gynecology

242

150

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Objective: The objective of this study was to evaluate the prevalence of placenta accreta spectrum in general population studies and the main maternal outcomes at delivery. Study design: Data sources: We searched PubMed, Google Scholar, clinicalTrials.gov and MEDLINE between 1982 and 2018. Study eligibility criteria: Articles providing data on the number of cases of placenta accreta spectrum per pregnancies, births or deliveries in a defined population. Study appraisal and synthesis methods: Study characteristics were evaluated by two independent reviewers using a predesigned protocol. Primary outcomes were the prevalence of placenta accreta spectrum and clinical diagnostic at birth and pathologic criteria used to confirm the diagnosis. Secondary outcomes included cases requiring transfusion, incidence of peripartum hysterectomy and maternal mortality rates. Heterogeneity between studies was analysed with the Cochran's Q-test and the I 2 statistics. Results: Of the 98 full-text studies identified, 29 articles met the defined criteria including 22 retrospective and 7 prospective studies comprising 7,001 cases of placenta accreta spectrum out 5,719,992 births. Prevalence rates ranged between 0.01 and 0.1% with an overall pooled prevalence of 0.17% (95% CI 0.14-0.19). Only 10 studies provided with detailed histopathologic data. The pool prevalence for the adherent versus the invasive grades was 0.5 (95% CI 0.3-0.36) and 0.3 (95% CI 0.2-0.4) per 1000 births, respectively. The pooled incidence for peripartum hysterectomy was 52.2% 4 (95% CI 38.3-66.4; I 2 = 99.8%) and 46.9% (95 % CI 34-59.9, I 2 = 98.8%) for haemorrhage requiring transfusion. The pooled estimate of maternal death was 0.05% (95% CI 0.06-0.69, I 2 =73%). We found large amounts of heterogeneity between studies for all parameters and further quantifying was limited because of methodological inconsistencies between studies with regards to clinical criteria used for the diagnosis of the condition at birth and the histopathologic confirmation of the diagnosis and differential diagnosis between adherent and invasive accreta placentation. Conclusions: This meta-analysis indicates wide variation between studies for the prevalence rate of placenta accreta spectrum and for the different grades of accreta placentation, highlighting the need for consistency in definitions used to describe placenta accreta spectrum at birth and in reporting on this increasing common obstetric complication.

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Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Prevalence and main outcomes of placenta accreta spectrum: a systematic review and meta-analysis

Jauniaux

Bunce

Grønbeck

et al. 2019

American Journal of Obstetrics and Gynecology

242

150

View full text Add to dashboard Cite

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“…[13][14][15] Prenatal diagnosis of PA has therefore become essential for the safe management of this increasingly common obstetric complication. [16][17][18] However, recent studies from UK and USA show that PA was undiagnosed before delivery in between half 19 and a third 20 of the cases. Determining the depth of placental invasion is essential for planning of individual management of women diagnosed with PA.…”

Section: Introductionmentioning

confidence: 99%

Accreta placentation: a systematic review of prenatal ultrasound imaging and grading of villous invasiveness

Jauniaux

Collins

Jurkovic

et al. 2016

American Journal of Obstetrics and Gynecology

181

226

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The wide heterogeneity in terminology used to describe the grades of accreta placentation and differences in study design limits the evaluation of the accuracy of ultrasound imaging in the screening and diagnosis of placenta accreta. This review emphasizes the need for further prospective studies using a standardized evidence-based approach including a systematic correlation between ultrasound signs of placenta accreta and detailed clinical and pathologic examinations at delivery.

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“…The complications of placenta previa-accreta can be life-threatening, thus, pre-operative prediction of these adverse outcomes is of great importance [9,10]. Several articles have provided models to predict placental invasion [11][12][13] in cases with placenta previa and prior cesarean.…”

Section: Introductionmentioning

confidence: 99%

Prediction of cesarean hysterectomy in placenta previa complicated with prior cesarean: a retrospective study

Liu

Deng

Lin

et al. 2020

BMC Pregnancy Childbirth

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Background: The prevalence of both placenta previa and cesarean are on the rise. Multiple adverse outcomes are critically increased when placenta previa is subsequent to prior cesarean. The purpose of the present study is to develop a pre-surgical method for predicting adverse outcomes in pregnancy complicated with both placenta previa and prior cesarean. Methods: Clinical data was obtained from the medical history system at the First Affiliated Hospital of Sun Yat-sen University from February 2003 to December 2016. All cases with a final diagnosis of "placenta previa/low lying placenta (ICD:O44.001-105)" and "scarred uterus complicated with pregnancy (ICD: O34.200-202)" were collected and reviewed. Hysterectomy was taken as the primary outcome; and blood loss was taken as the secondary outcome. Results: Of 219 pregnant women in the final analysis, 25 received a hysterectomy following delivery, and 48 had blood loss exceeding 1000 ml. Pre-surgical risk factors for hysterectomy are ultrasonic signs of vascular lacunae, central placenta previa, and loss of normal hypoechoic retroplacental zone. A pre-surgical predictive equation referred to as "Hysterectomy Index in Placenta Previa with Prior cesarean (HIPs)" was generated and each risk factor was weighted to create an 8-point scale. This index yielded an area under the curve of 0.972 for the prediction of hysterectomy. Conclusions: Application of the HIPs score may provide an effective pre-surgical prediction of cesarean hysterectomy in pregnant women complicated with both placenta previa and prior cesarean.

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Outcomes of Prospectively Collected Consecutive Cases of Antenatal-suspected Placenta Accreta

Cited by 10 publications

References 0 publications

Prevalence and main outcomes of placenta accreta spectrum: a systematic review and meta-analysis

Prevalence and main outcomes of placenta accreta spectrum: a systematic review and meta-analysis

Accreta placentation: a systematic review of prenatal ultrasound imaging and grading of villous invasiveness

Prediction of cesarean hysterectomy in placenta previa complicated with prior cesarean: a retrospective study

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