ACR Appropriateness Criteria® Placenta Accreta Spectrum Disorder

Imaging:, Expert Panel on Women’s; Pōder, Liina; Weinstein, Stefanie; Maturen, Katherine E.; Feldstein, Vickie A.; MacKenzie, David; Oliver, Edward R.; Shipp, Thomas; Strachowski, Loretta M; Sussman, Betsy L; Wang, Eileen Y.; Weber, Therese M.; Whitcomb, Bradford P.; Glanc, Phyllis

doi:10.1016/j.jacr.2020.01.031

Cited by 14 publications

(14 citation statements)

References 48 publications

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“…We reviewed relevant recommendations related to the 12 clinical/diagnostic scenarios previously published by radiology and specialty societies, including: the Canadian Association of Radiologists, 9 the American College of Obstetricians and Gynecologists, 10,11 the American College of Radiology, 12 -28 the American Society of Clinical Oncology, 29 the European Society of Urogenital Radiology Scrotal and Penile Imaging Working Group, 30,31 the European Society of Urogenital Radiology, 32 the French College of Gynecologists and Obstetricians, 33 the International Society of Ultrasound in Obstetrics and Gynecology, 34 the International guideline on polycystic ovarian syndrome, 35 -38 the National Institute for Health and Care Excellence, 39 -47 the Society for Maternal-Fetal Medicine, 48 the Society of Abdominal Radiology, 49 the Society of Obstetricians and Gynaecologists of Canada, 50 -57 the Royal College of Obstetricians and Gynaecologists, 58 -60 and the 2017 Royal College of Radiologists. 61…”

Section: Resultsmentioning

confidence: 99%

“…OG02. 2 ND TRIMESTER ASSESSMENT 9,10,[15][16][17][18][19]34,39,42,50,55,[58][59][60][61] 1. In patients in the 2 nd trimester of pregnancy, typically between 18-20 weeks, we recommend routine screening with transabdominal US, for evaluation of fetal anatomy, fetal growth, and general assessment of the placenta (↑↑).…”

Section: Clinical/diagnostic Scenario and Recommendationsmentioning

confidence: 99%

“…9,11,[15][16][17][19][20][21]34,48,55,59,61 1. In patients in the third trimester who have not received a 1 st or 2 nd trimester diagnostic US, we recommend transabdominal US for general assessment of the pregnancy (↑↑).…”

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confidence: 99%

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Canadian Association of Radiologists Obstetrics and Gynecology Diagnostic Imaging Referral Guideline

Hamel,

Amir,

Avard

et al. 2023

Can Assoc Radiol J

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The Canadian Association of Radiologists (CAR) Obstetrics and Gynecology Expert Panel consists of radiologists specializing in obstetrics and gynecology, obstetrics and gynecology physicians, a patient advisor, and an epidemiologist/guideline methodologist. After developing a list of 12 clinical/diagnostic scenarios, a systematic rapid scoping review was undertaken to identify systematically produced referral guidelines that provide recommendations for one or more of these clinical/diagnostic scenarios. Recommendations from 46 guidelines and contextualization criteria in the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) for guidelines framework were used to develop 68 recommendation statements across the 12 scenarios related to the evaluation of obstetrics and gynecology clinical and diagnostic scenarios. This guideline presents the methods of development and the imaging recommendations for a variety of obstetrical and gynecological conditions including pregnancy assessment, recurrent first trimester pregnancy loss, post-partum indications, disorders of menstruation, localization of intra-uterine contraceptive device, infertility assessment, assessment of adnexal mass, pelvic pain of presumed gynecological origin, and pelvic floor evaluation.

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Section: Resultsmentioning

confidence: 99%

Section: Clinical/diagnostic Scenario and Recommendationsmentioning

confidence: 99%

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Canadian Association of Radiologists Obstetrics and Gynecology Diagnostic Imaging Referral Guideline

Hamel,

Amir,

Avard

et al. 2023

Can Assoc Radiol J

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“…In conclusion, the implementation of new strategies for the diagnosis and management of PAS disorders, including the use of MRI for cases where ultrasound is inconclusive and delivery planning by an experienced surgical team in collaboration with other specialities (interventional radiology, urology, haematology, blood bank and intensive care unit (ICU)) has been shown to be of the utmost importance for the management of PAS disorders [1][2][3][4][5][6]29,30].…”

Section: Discussionmentioning

confidence: 99%

Placenta Accreta Spectrum (PAS) Disorders: Lessons Learned from the Introduction of Different Management Strategies in an Australian Tertiary Hospital. Retrospective Study (2004 to 2020)

Caldas¹,

Parr²,

Adno³

et al. 2023

Clin. Exp. Obstet. Gynecol.

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Background: Placenta accreta spectrum (PAS) disorder refers to pathologic adherence of the placenta and presents multiple perinatal challenges, accounting for between 30-50% of emergency peripartum hysterectomies. Accurate prenatal diagnosis allows multidisciplinary management and delivery at centres with experience and has been shown to improve perinatal outcomes. This study aims to analyse the results of implementing different strategies across the years on the diagnosis and management of PAS in a tertiary Australian hospital (Liverpool Hospital) including: the use of magnetic resonance imaging (MRI) and the benefits of the use of iliac artery balloons and ureteric stents. Secondary objectives include analysis of the risk factors and outcomes. Methods: Retrospective case series of 34 pregnancies complicated by PAS disorders, diagnosed between 2004 and 2020, and delivered at Liverpool Hospital. Descriptive and analytic study (with a significance level of p ≤ 0.05), approved by the Research Ethics and Governance Information System. Results: The incidence of PAS was 0.6 per 1000 deliveries. The typical risk factors (previous uterine surgeries and placenta praevia) were present in 79% of the cases. MRI was used in 39% of the cases (when ultrasound was inconclusive or placenta posterior) and was only inconclusive in 1 case. In total, 32% required emergency delivery due to haemorrhage or preterm labor. The overall complications rate was 32%. Ureteric stents were used in 44% of the cases and there were no ureteric injuries. The use of iliac balloons reduced the total blood loss (2.5 L compared to 2.8 L), however this difference was not statistically significant (p = 0.21). Conclusions: The prenatal diagnosis of PAS is essential to allow optimal perinatal management of these cases. The use of MRI appears helpful when ultrasound is inconclusive. In our study, the use of iliac balloons reduced blood loss, although this was not statistically significant, and ureteric stents appeared useful to avoid ureteric injury in the most complex cases, although the sample is very small. We hope that our study will help us improving our clinical practice.

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“…Placenta accreta spectrum disorder (PASD) is the current terminology recommended by the International Federation of Obstetrics and Gynecology (FIGO) [10] and at the present stage replaces terms such as abnormally adherent/ invasive placenta or morbidly adherent placenta. The term PASD refers to the many potential clinical complications that can result from improper placental implantation.…”

Section: Review and Discussionmentioning

confidence: 99%

Current State of the Problem Ofabnormal Invasion of the Placenta in Obstetrics

et al. 2020

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The aim: On the basis of literature data, as well as a clinical case study, to assess the state of the problem of abnormal invasion of the placenta in obstetrics at the present stage. Materials and methods: Based on the materials of the world’s leading citation databases (MEDLINE, EMBASE, Cochrane), a brief review of the literature data over the past 5 years is presented, dedicated to the issues of abnormal placental invasion. The possibilities of a complex of diagnostic studies and clinical management of women with an anomaly of placenta attachment are considered. A clinical case study of abnormal placental invasion is presented. Conclusions: AIP is an extremely serious condition with not fully understood etiological and pathogenic mechanisms. Correct and timely verification of this pathological condition, based on the simultaneous use of a whole complex of diagnostic studies (history taking, 2D, 3D, energy and color Doppler mapping, MRI), contributes to the development of individual tactics for the management and delivery in women with AIP, making it possible to reduce maternal morbidity and mortality and improve perinatal outcomes.

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ACR Appropriateness Criteria® Placenta Accreta Spectrum Disorder

Cited by 14 publications

References 48 publications

Canadian Association of Radiologists Obstetrics and Gynecology Diagnostic Imaging Referral Guideline

Canadian Association of Radiologists Obstetrics and Gynecology Diagnostic Imaging Referral Guideline

Placenta Accreta Spectrum (PAS) Disorders: Lessons Learned from the Introduction of Different Management Strategies in an Australian Tertiary Hospital. Retrospective Study (2004 to 2020)

Current State of the Problem Ofabnormal Invasion of the Placenta in Obstetrics

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