Cervical Length in Patients at Risk for Placenta Accreta

Rac, Martha; McIntire, Donald D.; Wells, C. Edward; Moschos, Elysia; Twickler, Diane D.

doi:10.7863/ultra.16.05059

Cited by 13 publications

(9 citation statements)

References 29 publications

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“…There is some correlation with cervical length and the risk of preterm birth with previa (less likely with a longer cervix) (41e43), but cervical length has not been extensively evaluated in placenta accreta spectrum. One small study noted no increase in the risk of preterm birth with short cervix and accreta (44). Placenta previa is not a contraindication to transvaginal ultrasonography, and ultrasound examination may provide important information about placenta accreta spectrum and previa in addition to cervical length (35).…”

Section: Obstetric Care Consensusmentioning

confidence: 99%

Placenta Accreta Spectrum

Cahill

Beigi

Heine

et al. 2018

American Journal of Obstetrics and Gynecology

290

184

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Section: Obstetric Care Consensusmentioning

confidence: 99%

Placenta Accreta Spectrum

Cahill

Beigi

Heine

et al. 2018

American Journal of Obstetrics and Gynecology

290

184

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“…[12] A previous ultrasound study showed that women with IPP had shorter cervical lengths at 32 to 34 weeks than women with a non-adherent low-lying placenta or placenta previa. [21] Our results showed that patients with the S2 involvement had shorter cervical lengths than the patients with the S1 invasion. Measurement of cervical lengths could help to depict the S2 invasion and increase the accuracy of topographic evaluation.…”

Section: Discussionmentioning

confidence: 62%

Morphological evaluation of cervix using MRI at 32 to 36 weeks of gestation

Liu¹,

Chen

Wei³

et al. 2018

Medicine

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This study is to investigate the role of cervical morphology evaluated by magnetic resonance imaging (MRI) in predicting invasive placenta previa (IPP).Totally 105 cases of pregnant women underwent prenatal placental MRI at 32 to 36 weeks of gestation for suspected IPP were included in this study. Cervical morphology (cervical length and placental protrusion) was evaluated independently by 2 radiologists. The association between the cervical morphology and surgery findings was analyzed.Totally, 57 pregnant women were confirmed as IPP. For invasion degree, there were 17 cases with placenta percreta and 40 with accreta. For invasion topography, there were 27 cases with S1 invasion and 30 with S2 invasion. The sensitivity and specificity for the MRI sign of placental protrusion in evaluating cervical invasion of IPP were 100% and 100%, respectively. All the 7 IPP patents with cervical invasion received total hysterectomy and had severe blood loss (3500–6000 mL). The IPP patients with S2 invasion had shorter cervical length than those with S1 invasion (2.66 ± 0.66 cm vs 3.24 ± 0.64 cm, P <.001). However, cervical lengths did not correlate with the degree of invasion (placenta percreta vs placenta accreta: 2.82 ± 0.86 vs 2.99 ± 0.60, P = .21).Placental protrusion is a reliable MRI sign for cervical invasion of IPP, and cervical lengths correlate with the invasion topography.

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“…35 Rather than having an arbitrary gestational age, some authors have advocated for an individualized and patient-specific risk dependent approach. [36][37][38] 39,40 The authors acknowledge that individualized and patient-specific risk decision analysis are often part of this complex decision process; additional data are needed to further inform on this area.…”

Section: Discussionmentioning

confidence: 99%