Identifying Sonographic Markers for Placenta Accreta in the First Trimester

Ballas, Jerasimos; Pretorius, Dolores H.; Hull, Andrew; Resnik, Robert; Ramos, Gladys A.

doi:10.7863/jum.2012.31.11.1835

Cited by 67 publications

(61 citation statements)

References 19 publications

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“…The histologic findings from the placenta were consistent with placenta increta. Ballas et al 31 reported a retrospective review of 10 cases of women undergoing cesarean deliveries for morbidly adherent placentas followed by hysterectomies in which the histologic findings showed placenta accreta. At gestational ages of 8 to 14 weeks, the pregnancies fulfilled the diagnostic criteria of cesarean scar pregnancies.…”

Section: Discussionmentioning

confidence: 99%

Cesarean Scar Pregnancies

Timor‐Tritsch

Khatib

Monteagudo

et al. 2015

J of Ultrasound Medicine

124

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Objectives To evaluate the management, clinical courses, and outcomes of cesarean scar pregnancies diagnosed in the first trimester. Methods We identified 60 cases of cesarean scar pregnancies diagnosed between 5 and 14 weeks. Group A contained 48 patients with fetal/embryonic cardiac activity; group B comprised 12 patients without cardiac activity; and group C included 11 patients with cardiac activity who chose expectant management. Results Five of the 48 patients (10.4%) in group A were successfully treated for vaginal bleeding. Thirty‐three (68.7%) received methotrexate injections, and all had full resolution. Three (6.3%) required uterine artery embolization for late‐developing arteriovenous malformations. Ten of the 12 patients (83.3%) in group B were managed expectantly and had full recovery. Two of the 10 (20.0%) had arteriovenous malformations; 1 had unsuccessful uterine artery embolization followed by a hysterectomy, and the second requested a hysterectomy. Ten of the 11 patients (90.9%) in group C continued the pregnancies. One declined local injection. Four of the 10 (40.0%) delivered live offspring by successive elective cesarean deliveries. Three (30.0%) had hysterectomies for placenta percreta, and 1 did not have a hysterectomy after delivery. Five (50%) had second‐trimester complications, all leading to hysterectomies. Of the 60 patients, 20 (33.3%) had serious complications: 5 had arteriovenous malformations; 4 had uterine artery embolization; and 11 had hysterectomies. Conclusions A cesarean scar pregnancy is a serious complication for patients who have had cesarean deliveries. Counseling, treatment, and follow‐up are challenging for patients and caregivers. However, emerging data from different management approaches confirm that a cesarean scar pregnancy may progress and result in a live neonate at the expense of further fertility. This study confirmed that expectant management of a cesarean scar pregnancy is associated with a high risk of hysterectomy due to morbidly adherent placenta.

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Section: Discussionmentioning

confidence: 99%

Cesarean Scar Pregnancies

Timor‐Tritsch

Khatib

Monteagudo

et al. 2015

J of Ultrasound Medicine

124

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“…19 In the first trimester, findings that suggest placenta accreta are low implantation of the gestational sac, lacunae, 25 and irregularity of the placental myometrial interface. 26 It is important to recognize first trimester findings because extensive hemorrhage during dilation and curettage and first trimester uterine rupture have been reported. 27 There has also been an increase in the frequency of cesarean section ectopic pregnancies (Fig.…”

Section: Ultrasound Findingsmentioning

confidence: 99%

Ultrasound Imaging of Placenta Accreta With MR Correlation

Mar

Berggruen

Atueyi

et al. 2015

Ultrasound Quarterly

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Placenta accreta is abnormal placental adherence or invasion of the myometrium or extrauterine structures. It is increasing in incidence because of increasing number of cesarean sections and is one of the main causes of excessive postpartum hemorrhage. Recognition of this entity is crucial because improved outcomes have been shown when the antenatal diagnosis of placenta accreta is made. Ultrasound is the first-line tool; magnetic resonance imaging (MRI) is complementary. Ultrasound and MRI features and MRI protocols will be reviewed.

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“…She admitted to our clinic with rupture of membranes; and placenta previa was not observed in her ultrasonographic evaluation. The increased incidence of placenta accreta has been reported in the pregnancies observed to have gestational sac, located close to the previous cesarean incision, in the lower uterine segment [14]. After the removal of the placenta and balloon tamponade of the uterus, there was not any active vaginal bleeding, causing suspicion of placenta accreta.…”

Section: Discussionmentioning

confidence: 99%

Placenta accreta located in the posterior wall of the uterus: a case report

Özler¹,

Öztaş²,

Kadıoğlu³

et al. 2016

Med-Science

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Abnormal invasive implantation of the placenta is thought to occur as a result of the defect in the decidua basalis of the women who have a history of cesarean delivery. Massive obstetric hemorrhage incidence is increased in placenta accreta cases. Although ultrasonographic and doppler examinations, and magnetic resonance imaging (MRI) are widely used, the diagnosis of placenta accreta in the early pregnancy weeks is poor. Therefore, the presence of life-threatening vaginal bleeding in the early pregnancy weeks must create a suspicion of placenta accreta. In this report, we will present a second trimester placenta accreta case, which was located on the posterior uterine wall.

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Identifying Sonographic Markers for Placenta Accreta in the First Trimester

Cited by 67 publications

References 19 publications

Cesarean Scar Pregnancies

Cesarean Scar Pregnancies

Ultrasound Imaging of Placenta Accreta With MR Correlation

Placenta accreta located in the posterior wall of the uterus: a case report

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