Special Report of the Society for Maternal-Fetal Medicine Placenta Accreta Spectrum Ultrasound Marker Task Force: Consensus on definition of markers and approach to the ultrasound examination in pregnancies at risk for placenta accreta spectrum

Abstract

ISUOG) support this document. The Society of Radiologists in Ultrasound (SRU) approves this document.Placenta accreta spectrum includes the full range of abnormal placental attachment to the uterus or other structures, encompassing placenta accreta, placenta increta, placenta percreta, morbidly adherent placenta, and invasive placentation. The incidence of placenta accreta spectrum has increased in recent years, largely driven by increasing rates of cesarean delivery. Prenatal detection of placenta accreta spectrum is primarily made by ultrasound and is important to reduce maternal morbidity associated with the condition. Despite a large body of research on various placenta accreta spectrum ultrasound markers and their screening performance, inconsistencies in the literature persist. In response to the need for standardizing the definitions of placenta accreta spectrum markers and the approach to the ultrasound examination, the Society for Maternal-Fetal Medicine convened a task force with representatives from the American Institute of Ultrasound in Medicine, the American College of Obstetricians and Gynecologists, the American College of Radiology, the International Society of Ultrasound in Obstetrics and Gynecology, the Society for Radiologists in Ultrasound, the American Registry for Diagnostic Medical Sonography, and the Gottesfeld-Hohler Memorial Ultrasound Foundation. The goals of the task force were to assess placenta accreta spectrum sonographic markers on the basis of available data and expert consensus, provide a standardized approach to the prenatal ultrasound evaluation of the uterus and placenta in pregnancies at risk of placenta accreta spectrum, and identify research gaps in the field. This manuscript provides information on the Placenta Accreta Spectrum Task Force process and findings.

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

“…AIP consists of the conditions that were previously known as placenta increta and placenta percreta; as the severe end of the PAS spectrum, AIP is associated with increased maternal morbidity and mortality and a higher rate of unsuccessful conservative treatment compared to the milder AAP [2][3][4][5]. The American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM) joint consensus guideline states that prenatal diagnosis of PAS is crucial, as the diagnosis can lead to a decrease in maternal morbidity [6][7][8][9][10].…”

Role of Abdominal Aortic Balloon Placement in Planned Conservative Management of Placenta Previa With Placenta Increta or Percreta

“…The placenta accreta spectrum (PAS), which includes placenta accreta, placenta increta, and placenta percreta, is primarily considered an entirely iatrogenic condition ( 1 , 2 ). The increasing rates of cesarean deliveries and other surgeries or intrauterine manipulation that injures the endometrium have resulted in an increase in the incidence of PAS and placenta previa ( 3 ).…”

Placenta accreta spectrum disorder: updates on anesthetic and surgical management strategies

“…20 Ultrasound is the primary diagnostic modality for the antenatal diagnosis of PAS. 16,17,21 An adjunct imaging modality is magnetic resonance imaging (MRI), but its diagnostic utility is less clear. Magnetic resonance imaging may be helpful when ultrasound findings are equivocal or when placental location is not predominantly anterior.…”