Ultrasound accuracy in prenatal diagnosis of abnormal placentation of posterior placenta previa

Garofalo, Anna; Pilloni, Eleonora; Alemanno, Maria Grazia; Garofalo, Giulia; Sciarrone, Andrea; Todros, Tullia; Viora, E.

doi:10.1016/j.ejogrb.2019.09.021

Cited by 22 publications

(31 citation statements)

References 24 publications

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“…A total of 468 articles were identified. After screening the abstracts, 80 full-text articles were assessed with respect to their eligibility for inclusion (Table S2) and 20 studies were included in the systematic review (Table 1, Figure 1) [25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44] . These studies included 2619 women at risk for PAS, of whom 812 (31.0% (95% CI, 29.2-32.9%)) were affected by PAS and 126 (4.8% (95% CI, 4.0-5.7%)) were affected by posterior PAS.…”

Section: General Characteristicsmentioning

confidence: 99%

“…Figure 1 Flowchart summarizing inclusion in systematic review of studies on posterior placenta accreta spectrum disorder. 25 Morgan (2019) 26 Ishibashi ( 2017) 27 Lee (2017) 28 Budorick (2017) 29 Balcacer (2016) 30 Pilloni (2016) 31 Gilboa (2015) 32 Kelekci (2015) 33 Riteau (2014) 34 Zhou (2014) 35 Elhawary (2013) 36 Calì (2013) 37 Palacios-Jaraquemada (2013) 39 Wong (2012) 38 Lim (2011) 40 Masselli (2008) 41 Dwyer (2008) 42 Warshak (2006) 43 Chou (2000) 44 Only first author's name is given for each study. According to NOS, a study can be awarded a maximum of one star for each numbered item within the selection and outcome categories.…”

Section: Studies Included In Quantitative Synthesismentioning

confidence: 99%

“…Seventeen studies (114 women) reported the occurrence of different risk factors in women affected by posterior PAS [25][26][27][28][29][30][31][32][33][36][37][38][40][41][42][43][44] . Placenta previa was present in 92.8% (95% CI, 86.2-97.4%) of pregnancies complicated by posterior PAS, while 76.1% (95% CI, 52.4-93.4%) had had prior uterine surgery, mainly CS; both placenta previa and prior uterine surgery were present in 72.6% (95% CI, 47.9-91.5%) of women (Table 3, Figure S1) 25,26,28,29,33,36,37,[40][41][42][43] . None of the included cases had a prior TOP or insertion of an intrauterine device before pregnancy, while 38.0% (95% CI, 18.5-59.7%) were conceived by IVF, although these figures are based upon a very limited number of cases 26,37 .…”

Section: Risk Factors and Histopathologymentioning

confidence: 99%

See 2 more Smart Citations

Risk factors, histopathology and diagnostic accuracy in posterior placenta accreta spectrum disorders: systematic review and meta‐analysis

Tinari

Buca

Calì

et al. 2021

Ultrasound in Obstet & Gyne

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The findings of this systematic review show a high incidence of placenta previa, prior uterine surgery -mainly Cesarean section or curettage -and multiparity in pregnancies complicated by posterior placenta accreta spectrum (PAS) disorder. The detection rate of magnetic resonance imaging (MRI) in identifying posterior PAS prenatally was higher than that of ultrasound, with more than two-thirds of cases identified before surgery. What are the clinical implications of this work?The findings of this review support the need to perform a detailed ultrasound assessment of women with posterior placenta previa and prior uterine surgery in order to rule out PAS. MRI should be considered in women with posterior placenta previa presenting with other risk factors for PAS, such as curettage, even when the classical ultrasound signs are not present.

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Section: General Characteristicsmentioning

confidence: 99%

Section: Studies Included In Quantitative Synthesismentioning

confidence: 99%

Section: Risk Factors and Histopathologymentioning

confidence: 99%

See 1 more Smart Citation

Risk factors, histopathology and diagnostic accuracy in posterior placenta accreta spectrum disorders: systematic review and meta‐analysis

Tinari

Buca

Calì

et al. 2021

Ultrasound in Obstet & Gyne

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“…The risk of PAS disorders correlates with the number of previous caesarean sections (CSs) [6,7]. The detection of further significant risk factors such as placenta praevia has made targeted screening possible [8,9]. Sonographic markers for PAS disorders were found and standardised [10].…”

Section: Introductionmentioning

confidence: 99%

Placenta accreta spectrum disorders—experience of management in a German tertiary perinatal centre

Bluth

Schindelhauer

Nitzsche

et al. 2020

Arch Gynecol Obstet

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Purpose Placenta accreta spectrum (PAS) disorders can cause major intrapartum haemorrhage. The optimal management approach is not yet defined. We analysed available cases from a tertiary perinatal centre to compare the outcome of different individual management strategies. Methods A monocentric retrospective analysis was performed in patients with clinically confirmed diagnosis of PAS between 07/2012 and 12/2019. Electronic patient and ultrasound databases were examined for perinatal findings, peripartum morbidity including blood loss and management approaches such as (1) vaginal delivery and curettage, (2) caesarean section with placental removal versus left in situ and (3) planned, immediate or delayed hysterectomy. Results 46 cases were identified with an incidence of 2.49 per 1000 births. Median diagnosis of placenta accreta (56%), increta (39%) or percreta (4%) was made in 35 weeks of gestation. Prenatal detection rate was 33% for all cases and 78% for placenta increta. 33% showed an association with placenta praevia, 41% with previous caesarean section and 52% with previous curettage. Caesarean section rate was 65% and hysterectomy rate 39%. In 9% of the cases, the placenta primarily remained in situ. 54% of patients required blood transfusion. Blood loss did not differ between cases with versus without prenatal diagnosis (p = 0.327). In known cases, an attempt to remove the placenta did not show impact on blood loss (p = 0.417). Conclusion PAS should be managed in an optimal setting and with a well-coordinated team. Experience with different approaches should be proven in prospective multicentre studies to prepare recommendations for expected and unexpected need for management.

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“…The traditional classi cation of PP was complete PP (the placenta covers the internal os completely), partial PP (the placenta covers the internal os partially), marginal PP (the placental edge just reaches the margin of the internal os), and low-lying placenta (the placental edge is within 2 cm of the internal os) [8]. Advances in ultrasonography have enabled its use to evaluate suspected PP [9]. Currently, determining the location of the placenta using ultrasonography during mid-pregnancy is a routine practice [2].…”

Section: Introductionmentioning

confidence: 99%

Effect of types of placenta previa on maternal and neonatal outcomes: a 10-year retrospective cohort study

Zhang

Wang

et al. 2021

Arch Gynecol Obstet

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Purpose: Through this study, we aimed to evaluate the effects of different types of placenta previa (PP) on maternal and neonatal outcomes.Methods: This study was conducted in The Third A liated Hospital of Guangzhou Medical University and Tongji Hospital between January 2009 and 2019. PP was traditionally classi ed into four types, namely low-lying placenta, marginal, partial, and complete PP. Previous studies have classi ed PP into two types, namely low-lying placenta and PP. Based on our clinical experience, we proposed the classi cation of PP into three types, for the rst time, which included low-lying placenta, "marpartial" (marginal and partial) PP, and complete PP. Multivariate logistic regression analysis was performed to determine the effects of different types of PP on maternal and neonatal outcomes.Results: In total, 4490 singleton pregnancies were complicated with PP. In the four-classi cation method, compared with women with low-lying placenta, women with complete PP had a risk of placenta accrete spectrum disorders, postpartum hemorrhage (PPH), hemorrhagic shock, severe PPH, blood transfusion, hysterectomy, puerperal infection, preterm labor, NICU admission, and low birth weight. There was no difference in maternal and neonatal outcomes between marginal and partial PP, except for increased chances of preterm labor and low birth weight in partial PP. In the two-classi cation method, PP was the risk factor for most of the adverse maternal and neonatal outcomes, compared with low-lying placenta. Conclusion:Complete PP and low-lying placenta were associated with the highest and lowest risks of adverse pregnancy outcomes, respectively, whereas clinically similar outcomes were observed between marginal and partial PP. The three-classi cation of PP may be practical from the clinical perspective.

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Ultrasound accuracy in prenatal diagnosis of abnormal placentation of posterior placenta previa

Cited by 22 publications

References 24 publications

Risk factors, histopathology and diagnostic accuracy in posterior placenta accreta spectrum disorders: systematic review and meta‐analysis

Risk factors, histopathology and diagnostic accuracy in posterior placenta accreta spectrum disorders: systematic review and meta‐analysis

Placenta accreta spectrum disorders—experience of management in a German tertiary perinatal centre

Effect of types of placenta previa on maternal and neonatal outcomes: a 10-year retrospective cohort study

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