VP47.03: Can fetal abdominal wall thickness predict intrapartum complications amongst mothers with pre‐gestational type 2 diabetes? A cohort study

Abstract

Objectives: To show the efficacy of first trimester placental localisation in prediction of migration of low-lying placenta in cases of previous Caesarean section (CS) and the prediction of placenta accreta. Methods: The study was performed on 75 cases with history of one or more CS, single fetus, with placenta either covering or within 20mm from the internal cervical os. Patients were examined during the first visit at 11-14 weeks of gestation by transabdominal then transvaginal ultrasound. Direction of cord insertion was recorded; criteria of abnormal placental invasion were searched for using 2D and colour Doppler ultrasound. Patients were reexamined again during 24-32 weeks of gestation to report placental migration to the upper uterine segment. Cases that found in the lower segment within 20mm or covering the internal os were reported as placenta previa. Results: 87% of cases showed placental migration in third trimester. The direction of umbilical cord attachment to placenta showed highest sensitivity in prediction of placenta previa when recorded early in first trimester in comparison to the distance from the leading placental edge to the centre of the internal os and placental position. Conclusions: First trimester localisation of placenta by ultrasonography could predict placenta previa in cases with a history of previous CS and low-lying placenta.