245: Posterior placentation in morbidly adherent placenta: a nested case-control study of characteristics and outcomes

Abstract

STUDY DESIGN: We searched the Medline, EMbase, and Cochrane databases for English language articles using various search terms and combinations. We included cohort studies assessing a third trimester ultrasonographic AC measurement of <10 th percentile to predict SGA (defined as birth weight less than 10 th percentile or <2500g at term). We then performed a separate search for studies assessing EFW <10 th percentile to predict SGA. Case series and studies including anomalous fetuses or multiple gestations were excluded. We computed the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) with 95% confidence intervals (95% CI) of the 10 th percentile EFW and AC cutoffs to predict SGA. RESULTS: Our initial search identified 1957 studies assessing AC alone and 2460 studies assessing EFW to predict SGA at birth. Two investigators independently reviewed all titles and abstracts and identified 36 relevant studies for AC and 30 studies for EFW. These full text articles were reviewed in detail. Of these, 6 studies assessing AC met criteria for inclusion, totaling 16,420 subjects. Twelve studies assessing EFW were included, with a total of 15,696 subjects. We found that a single AC measured in the third trimester at <10 th percentile has a sensitivity of 38.9% and specificity of 94.0%, whereas EFW <10 th percentile has a sensitivity of 45.0% and specificity of 94.2% to predict SGA at birth. CONCLUSION: We found that a single AC measurement in the third trimester has comparable ability to predict SGA when compared to EFW.244 Correlation of 3D fractional limb volumes of the fetal thigh in fetal growth restriction (FGR) with normal and abnormal doppler studies OBJECTIVE: To compare the characteristics and outcomes in patients with posterior versus anterior morbidly adherent placenta (MAP).