Risk of placenta praevia is linked to endometrial thickness in a retrospective cohort study of 4537 singleton assisted reproduction technology births

Rombauts, Luk; Motteram, Caroline; Berkowitz, Elad; Fernando, Shavi

doi:10.1093/humrep/deu240

Cited by 77 publications

(75 citation statements)

References 39 publications

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“…Although IVF treatment was not recognised as a risk factor for AIP and was not included in the study protocol, six of the primiparous women (10%) had become pregnant through IVF . IVF pregnancies have known increased risk of low placentation, which may be due to thick endometrium …”

Section: Discussionmentioning

confidence: 99%

Abnormally invasive placenta—prevalence, risk factors and antenatal suspicion: results from a large population‐based pregnancy cohort study in the Nordic countries

Thurn

Lindqvist

Jakobsson

et al. 2015

BJOG

300

304

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Objective The objective was to investigate prevalence, estimate risk factors, and antenatal suspicion of abnormally invasive placenta (AIP) associated with laparotomy in women in the Nordic countries.Design Population-based cohort study.Setting and population A 3-year Nordic collaboration among obstetricians to identify and report on uterine rupture, peripartum hysterectomy, excessive blood loss, and AIP from 2009 to 2012 The Nordic Obstetric Surveillance Study (NOSS).Methods In the NOSS study, clinicians reported AIP cases from maternity wards and the data were validated against National health registries.Main outcome measures Prevalence, risk factors, antenatal suspicion, birth complications, and risk estimations using aggregated national data.Results A total of 205 cases of AIP in association with laparotomy were identified, representing 3.4 per 10 000 deliveries. The single most important risk factor, which was reported in 49% of all cases of AIP, was placenta praevia. The risk of AIP increased seven-fold after one prior caesarean section (CS) to 56-fold after three or more CS. Prior postpartum haemorrhage was associated with six-fold increased risk of AIP (95% confidence interval 3.7-10.9). Approximately 70% of all cases were not diagnosed antepartum. Of these, 39% had prior CS and 33% had placenta praevia. ConclusionOur findings indicate that a lower CS rate in the population may be the most effective way to lower the incidence of AIP. Focused ultrasound assessment of women at high risk will likely strengthen antenatal suspicion. Prior PPH is a novel risk factor associated with an increased prevalence of AIP.Keywords Incidence, placenta accreta, prenatal diagnosis, risk factors.Tweetable abstract An ultrasound assessment in women with placenta praevia or prior CS may double the awareness for AIP.

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Section: Discussionmentioning

confidence: 99%

Abnormally invasive placenta—prevalence, risk factors and antenatal suspicion: results from a large population‐based pregnancy cohort study in the Nordic countries

Thurn

Lindqvist

Jakobsson

et al. 2015

BJOG

300

304

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“…were the first to report a significantly increased risk of placenta praevia in patients with endometriosis compared with those without the disease (OR, 1.7; 95% CI, 1.2–2.4). In the large cohort study conducted by Rombauts et al., endometriosis was shown to be an independent risk factor for placenta praevia (OR, 2.0; 95% CI, 1.2–3.3). In the population‐based Japanese study of Harada et al., the OR of placenta praevia in women with endometriosis was almost halved (from 6.4 to 3.3) when only women without infertility treatment were considered.…”

Section: The Additional Effect Of Ivf Twinning and Blastocyst Transmentioning

confidence: 94%

“…In particular, transfer at blastocyst stage of two embryos obtained with oocyte donation should never be contemplated. Moreover, albeit evidence is not yet conclusive, physicians may consider cleavage rather than blastocyst transfer, and could implement freeze‐all policies . Indeed, recent data suggests an increased likelihood of placenta praevia associated with transfer of a day‐5 embryo and a lower risk in women undergoing elective frozen embryo transfer in a natural cycle …”

Section: Raising Awareness Limiting Risks and Informing Womenmentioning

confidence: 99%

“…Moreover, albeit evidence is not yet conclusive, physicians may consider cleavage rather than blastocyst transfer, and could implement freeze-all policies. 11 Indeed, recent data suggests an increased likelihood of placenta praevia associated with transfer of a day-5 embryo and a lower risk in women undergoing elective frozen embryo transfer in a natural cycle. 11 When pregnant women with rectovaginal lesions are diagnosed with placenta praevia, they should be referred to tertiary-care centres with experience in both deep endometriosis and surgically complex obstetrical cases.…”

Section: Raising Awareness Limiting Risks and Informing Womenmentioning

confidence: 99%

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The ominous association between severe endometriosis, in vitro fertilisation, and placenta previa: raising awareness, limiting risks, informing women

Vercellini

Frattaruolo

Barbara

et al. 2017

BJOG

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Please cite this paper as: Vercellini P, Frattaruolo MP, Barbara G, Buggio L, Somigliana E. The ominous association between severe endometriosis, in vitro fertilisation, and placenta previa: raising awareness, limiting risks, informing women. BJOG 2018;125:12-15. Endometriosis is associated with several adverse pregnancy outcomes.1 The most severe maternal complications are spontaneous haemoperitoneum in the second half of pregnancy and placenta praevia.1 Spontaneous haemoperitoneum, mostly associated with endometriosis infiltrating the broad and uterosacral ligaments and the Douglas pouch, is a potentially fatal but rare event. Placenta praevia is more common, 1-3 and it is important to define its incidence, the association with different lesion types, the impact of additional risk factors, the potential obstetrical consequences, and the information that women should receive.The association between endometriosis and placenta praevia Reliable estimates of the risk of placenta praevia in women with endometriosis could be obtained by investigating large population-based national cohorts. Harada et al.2 used data of the Japan Environment and Children's Study to evaluate obstetrical outcomes in 9186 pregnant women with (n = 330) or without (n = 8856) a self-reported history of endometriosis. Placenta praevia was observed in 3.6% of women with endometriosis and 0.6% of those without the disease (adjusted OR, 6.4; 95% CI, 3.2-12.6).2 Saraswat et al., using Scottish Record Linkage System data, compared late pregnancy outcomes in 4232 women with and 6707 without a diagnosis of endometriosis. The rate of placenta praevia was 1.7% in the former group and 0.8% in the latter (adjusted OR, 2.2; 95% CI, 1.5-3.3).3 Berlac et al., extracting data from the Danish Health Register and the Medical Birth Register, observed a higher risk of several obstetrical and neonatal complications in the 11 739 patients with endometriosis compared with the 615 533 women without a diagnosis of endometriosis. The highest risk was observed for pregnancies complicated by placenta praevia (2.1% versus 0.5%, respectively; OR, 3.9; 95% CI, 3.5-4.3).1

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“…Various hemostatic techniques have been reported to achieve hemostasis, although some methods are reported to be related to complications such as uterine necrosis or subsequent sterility [3][4][5]. In addition, there is an increased risk of placenta previa in pregnancies following use of assisted reproduction technology (ART) [6][7][8], where in some cases, peritoneal and/or pelvic adhesions may be increased, and compression sutures and cesarean hysterectomy would be very difficult. On the other hand, our method of applying figure-of-eight suturing for on-site bleeding points is very simple and can be performed even in cases with broad rectal or intestinal adhesions to the posterior wall of the uterus, which are sometimes seen in cesarean section following ART.…”

mentioning

confidence: 99%

On-site hemostatic suturing technique for uterine bleeding from placenta previa and subsequent pregnancy

Hamuro

Tachibana

Wada

et al. 2015

Arch Gynecol Obstet

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Risk of placenta praevia is linked to endometrial thickness in a retrospective cohort study of 4537 singleton assisted reproduction technology births

Abstract: No funding was required for this study. L.R. has a minority shareholding in Monash IVF and has received unconditional research and educational grants from MSD, Merck-Serono and Ferring. L.R. serves on an advisory board for MSD and Ferring.

Cited by 77 publications

References 39 publications

Abnormally invasive placenta—prevalence, risk factors and antenatal suspicion: results from a large population‐based pregnancy cohort study in the Nordic countries

Abnormally invasive placenta—prevalence, risk factors and antenatal suspicion: results from a large population‐based pregnancy cohort study in the Nordic countries

The ominous association between severe endometriosis, in vitro fertilisation, and placenta previa: raising awareness, limiting risks, informing women

On-site hemostatic suturing technique for uterine bleeding from placenta previa and subsequent pregnancy

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