Antenatal diagnosis of non‐previa placenta increta with histological confirmation

Wong, H. S.; Zuccollo, Jane; Parker, S.; Burns, K.; Tait, John; Pringle, Kevin C.

doi:10.1002/uog.2759

Cited by 23 publications

(17 citation statements)

References 15 publications

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“…Therefore, when healing or repair has occurred in patients with conservatively treated placenta accreta, trophoblasts are no longer recruited in subsequent pregnancies resulting in no recurrence, even when the same risk factors are present, as seen in some reports. 14 In conclusion, placenta accreta may present on sonography in early gestation as decidual/placental-uterine wall interface irregularity in a nondeficient decidual layer, and in later gestation as placental-uterine wall interface disruption, 15 which appears as a specific sign related to the histologic findings. 16 The observation of the regularity of the decidual layer may be useful in early detection of this condition in high-risk women.…”

Section: Discussionmentioning

confidence: 99%

Placenta accreta in the first trimester of pregnancy: Sonographic findings

Wong

Zuccollo

Tait

et al. 2008

J of Clinical Ultrasound

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In a case of histologically confirmed placenta increta, decidual protrusion into the myometrium was observed sonographically at 6 weeks' gestation, corresponding to placental protrusion from a disrupted placental-uterine wall interface seen in the later part of the first and second trimester. It is hypothesized that the histologic finding of decidual scarcity in placenta accreta is not a cause but rather an end result of the recruitment of trophoblasts across the decidual-placental interface in a maternal attempt at healing and/or repair in the presence of uterine injury, disease, or malformation that accounts for the associated factors and course of the condition.

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Section: Discussionmentioning

confidence: 99%

Placenta accreta in the first trimester of pregnancy: Sonographic findings

Wong

Zuccollo

Tait

et al. 2008

J of Clinical Ultrasound

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“…These sonographic findings are also consistent with the characteristic histologic finding in placenta accreta-the penetration of trophoblastic villi into myometrium in the absence of the intervening decidua. 21,22 For screening purposes, it may not be practical to look for every reported sonographic criterion in each woman. We have designed a composite score system that consists of a combination of some sensitive or specific criteria (Table 4).…”

Section: 3mentioning

confidence: 99%

Evaluation of sonographic diagnostic criteria for placenta accreta

Wong

Cheung

Zuccollo

et al. 2008

J of Clinical Ultrasound

124

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“…Sonographic findings were considered positive for accreta if the report concluded a high probability of placenta accreta. Findings that were considered suggestive of placenta accreta included loss of the retroplacental hypoechoic clear zone, loss of the bladder wall-uterine interface, presence of placental lacunae (vascular spaces), and presence of hypervascularity of the interface between the uterine serosa and the bladder wall on color Doppler imaging 7,8. Magnetic resonance imaging findings were considered positive for placenta accreta if the report concluded a high probability of placenta accreta.…”

Section: Methodsmentioning

confidence: 99%

“…The accuracy of sonography using gray scale and color Doppler techniques for prenatal diagnosis of placenta accreta varies widely in different studies. Its sensitivity has been reported as anywhere between 33% and 100%, and the specificity also varies widely 3–8. More recently, MRI, with and without gadolinium, has been explored as a modality for further improving the prenatal diagnosis of placenta accreta.…”

mentioning

confidence: 99%

Prenatal Diagnosis of Placenta Accreta

Dwyer

Belogolovkin

Tran

et al. 2008

Journal of Ultrasound in Medicine

185

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Objective The purpose of this study was to compare the accuracy of transabdominal sonography and magnetic resonance imaging (MRI) for prenatal diagnosis of placenta accreta. Methods A historical cohort study was undertaken at 3 institutions identifying women at risk for placenta accreta who had undergone both sonography and MRI prenatally. Sonographic and MRI findings were compared with the final diagnosis as determined at delivery and by pathologic examination. Results Thirty-two patients who had both sonography and MRI prenatally to evaluate for placenta accreta were identified. Of these, 15 had confirmation of placenta accreta at delivery. Sonography correctly identified the presence of placenta accreta in 14 of 15 patients (93% sensitivity; 95% confidence interval [CI], 80%–100%) and the absence of placenta accreta in 12 of 17 patients (71% specificity; 95% CI, 49%–93%). Magnetic resonance imaging correctly identified the presence of placenta accreta in 12 of 15 patients (80% sensitivity; 95% CI, 60%–100%) and the absence of placenta accreta in 11 of 17 patients (65% specificity; 95% CI, 42%–88%). In 7 of 32 cases, sonography and MRI had discordant diagnoses: sonography was correct in 5 cases, and MRI was correct in 2. There was no statistical difference in sensitivity (P = .25) or specificity (P = .5) between sonography and MRI. Conclusions Both sonography and MRI have fairly good sensitivity for prenatal diagnosis of placenta accreta; however, specificity does not appear to be as good as reported in other studies. In the case of inconclusive findings with one imaging modality, the other modality may be useful for clarifying the diagnosis.

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Antenatal diagnosis of non‐previa placenta increta with histological confirmation

Cited by 23 publications

References 15 publications

Placenta accreta in the first trimester of pregnancy: Sonographic findings

Placenta accreta in the first trimester of pregnancy: Sonographic findings

Evaluation of sonographic diagnostic criteria for placenta accreta

Prenatal Diagnosis of Placenta Accreta

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