Society of Abdominal Radiology (SAR) and European Society of Urogenital Radiology (ESUR) joint consensus statement for MR imaging of placenta accreta spectrum disorders

Jha, Priyanka; Pōder, Liina; Bourgioti, Charis; Bharwani, Nishat; Lewis, Sara; Kamath, Amita; Nougaret, Stéphanie; Soyer, Philippe; Weston, Michael; Castillo, Rosa; Kido, Aki; Forstner, Rosemarie; Masselli, Gabriele

doi:10.1007/s00330-019-06617-7

Cited by 118 publications

(118 citation statements)

References 50 publications

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“…In addition to uterine artery support, the blood supply of the uterus also includes the obturator artery, ovarian artery and femoral artery [33,34]. In PAS with placenta previa, the placenta is mostly located in the lower part of the uterus, the cervix and the upper part of the vagina, where many abnormal vascular anastomotic branches exist [35,36]. Through the extensive collateral circulation between the arteries in the pelvis, the branches originating from other blood vessels (i.e., the external iliac artery or the femoral artery) can quickly compensate for the occluded arteries of the uterus, which is not conducive to completely blocking uterine blood flow.…”

Section: Discussionmentioning

confidence: 99%

The application of prophylactic balloon occlusion of the internal iliac artery for the treatment of placenta accreta spectrum with placenta previa: a retrospective case-control study

Peng

Jiang

Cheng

et al. 2020

BMC Pregnancy Childbirth

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Background: Severe obstetric haemorrhage caused by placenta accreta spectrum (PAS) results in significant maternal morbidity and mortality. The effectiveness of prophylactic balloon occlusion of the internal iliac artery in PAS patients remains controversial. Therefore, we conducted a retrospective case-control study to investigate the clinical effectiveness of this treatment. Methods: The clinical data of 104 patients with PAS complicated with placenta previa who delivered by caesarean section between January 2016 and January 2019 were collected, and the patients were divided into two groups. The study group (48 cases) underwent internal iliac artery preset balloon occlusion before caesarean section and uterine artery embolisation according to the bleeding status after surgery, while the control group (56 cases) did not undergo internal iliac artery preset balloon occlusion before caesarean section. Results: The operation and hospitalisation times in the study group were longer than those in the control group. Additionally, the hysterectomy rate in the study group was significantly higher than that in the control group. No significant differences in blood loss, blood transfusion volume, urinary system injury, postoperative ICU transfer rate, or neonatal scores were identified between the groups. Among the patients without invasive placenta (placenta increta and percreta), blood loss was lower in the study group, and the caesarean hysterectomy rate did not significantly differ between the groups. Among the patients with invasive placenta, blood loss and the caesarean hysterectomy rate did not significantly differ between the groups. The risk of hysterectomy in the study group was related to invasive placenta penetration, a large area of placental invasion, or abnormal vascular filling. One patient in the study group had a thrombus in the left lower extremity artery.

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Section: Discussionmentioning

confidence: 99%

The application of prophylactic balloon occlusion of the internal iliac artery for the treatment of placenta accreta spectrum with placenta previa: a retrospective case-control study

Peng

Jiang

Cheng

et al. 2020

BMC Pregnancy Childbirth

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“…The study included five readers with clinical experience in evaluating patients with PAS, three readers for MRI and two readers for US. Before starting the image review, all readers reviewed a set of articles on imaging of PAS that provided standardized descriptors of PAS for each modality [29,32,33]. Blinded to the clinical data, the readers independently evaluated anonymized images for presence of placental bulge sign and for other findings of PAS depending on the given modality (Table S1).…”

Section: Image Interpretationmentioning

confidence: 99%

“…The reviewers had access to all images acquired as part of the examination. As proposed by the International Society for Abnormally Invasive Placenta (IS-AIP) and the joint Society of Abdominal Radiology (SAR) and European Society of Urogenital Radiology (ESUR) guidelines, placental bulge sign was defined for both modalities as a deviation of the uterine serosa from its expected plane by an abnormal bulge of placental tissue, though with the serosa still intact [29,32,33] (Figure 2). Following the independent readings, the readers for each modality resolved discrepancies for qualitative measurements.…”

Section: Image Interpretationmentioning

confidence: 99%

“…When placental bulge was considered present, the length and depth of the bulge were measured using similar instructions as used for measuring the bulge on US (Figure 2), based on the plane which the reader deemed the bulge to be best visualized. In addition, if placental bulge was present, readers recorded whether the bulge was located along the bladder interface, whether the bulge exhibited subjacent dark intraplacental bands, and whether abnormal vascularization of the placental bed was present at the site of the bulge (Figure 3) [28,33].…”

Section: Accepted Manuscriptmentioning

confidence: 99%

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Role of Ultrasound and MRI in Diagnosis of Severe Placenta Accreta Spectrum Disorder: An Intraindividual Assessment With Emphasis on Placental Bulge

Thiravit

Goldman

et al. 2021

American Journal of Roentgenology

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The publication of this Accepted Manuscript is provided to give early visibility to the contents of the article, which will undergo additional copyediting, typesetting, and review before it is published in its final form. During the production process, errors may be discovered that could affect the content of the Accepted Manuscript. All legal disclaimers that apply to the journal pertain. The reader is cautioned to consult the definitive version of record before relying on the contents of this document.

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“…In the second and third trimesters of pregnancy, the following ultrasound markers have been associated with PAS: placental lacunae (large, irregular intraplacental sonolucent spaces in the center of a cotyledon) with high-velocity feeder vessels, disruption of the bladder wall-uterine serosa interface (the “bladder line”), disruption of the normal hypoechoic area behind the placenta (known as the “clear space”), abnormal vascularity (vessels that extend from the placenta through the myometrium into the bladder or the serosa), placental bulge, and a focal exophytic mass (most often seen inside a filled urinary bladder) [ 14 , 15 ]. The “clear space” can be obscured at an advanced gestational age by pressure from the ultrasound probe and bladder filling or by posterior placental location.…”

Section: Discussionmentioning

confidence: 99%

Maternal and fetal outcome in placenta accreta spectrum (PAS) associated with placenta previa: a retrospective analysis from a tertiary center

et al. 2021

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Accreta placenta spectrum is a complex obstetrical condition of abnormal placental invasion associated with severe maternal morbidity. This study aimed to analyze our therapeutic management and counseling of the cases with placenta accreta spectrum (PAS) associated with placenta previa. We performed a retrospective study of pregnant women with PAS associated with placenta previa at the Filantropia Clinical Hospital between January 2017–April 2021. In these cases, the earlier diagnosis was realized by an ultrasonographic scan and was confirmed by histopathological findings after the surgical treatment. The conservative management was obtained in one case at <37 weeks of gestation, and the maternal outcome was uterine preservation. Among the 12 patients, the mean age was 34±3.44 years. All women had risk factors for abnormally invasive placenta, such as placenta previa or previous cesarean delivery. Most women underwent planned cesarean delivery at the mean gestational age of 36.4±0.9 weeks. In our study, the uterus was preserved in only one case (8.33%), and hysterectomy with preservation of ovaries was performed in the rest of the cases. Mean maternal blood loss during surgery was 2175±1440 ml. Severe maternal outcomes were recorded only in one case (8.33%). We identified a low uterine preservation rate and a good perinatal outcome. Conservative management should be reserved for fertility desire and extensive disease due to surgical difficulty. Early identification of the risk factors and strategic management may improve maternal and fetal outcomes.

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Society of Abdominal Radiology (SAR) and European Society of Urogenital Radiology (ESUR) joint consensus statement for MR imaging of placenta accreta spectrum disorders

Cited by 118 publications

References 50 publications

The application of prophylactic balloon occlusion of the internal iliac artery for the treatment of placenta accreta spectrum with placenta previa: a retrospective case-control study

The application of prophylactic balloon occlusion of the internal iliac artery for the treatment of placenta accreta spectrum with placenta previa: a retrospective case-control study

Role of Ultrasound and MRI in Diagnosis of Severe Placenta Accreta Spectrum Disorder: An Intraindividual Assessment With Emphasis on Placental Bulge

Maternal and fetal outcome in placenta accreta spectrum (PAS) associated with placenta previa: a retrospective analysis from a tertiary center

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