Prediction of morbidly adherent placenta using a scoring system

Abstract

Our proposed scoring system is highly predictive of MAP in patients at risk. This allows an adequate multidisciplinary team approach for the planning and timing of delivery in such cases. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.

Predictive values of ultrasound-based scoring system in morbidly adherent placenta for high risk group

“…Rac et al had created a equation for prediction of placental invasion based on ultrasound parameters which were studied in 88 pregnant women. 18 In present study the predictive values of the US scoring system for morbidly adherent placenta (sensitivity, specificity, positive and negative predictive values) were (92.3%, 94.1%, 87.453% and 98.2% respectively) and these results agreed with what had been reported by Tovbin et al 22 Logistic regression was used for examination the relationship between the variables of U/S that had been found to be significantly associated with MAP on univariable analysis and the operative diagnosis of MAP; the OR for MAP was 1.89 (95% Cl: 0.89-3.23) for the presence of placental lacunae and OR was 2.11 (95% Cl: 1.61-2.78) for lacunae Doppler blood flow. As regarding to the obliteration of the uteroplacental demarcation, the OR was 2.49 (95% Cl: 1.76-4.12).…”

“…As regarding to the obliteration of the uteroplacental demarcation, the OR was 2.49 (95% Cl: 1.76-4.12). As regarding to Hypervascularity of placenta-bladder interface, OR was 1.56 (95% Cl: 0.72-2.97) and as regarding to placental position, OR for anterior position of placenta was 2.67 (95% Cl: 1.23-3.82) and for posterior placenta was 1.34 (95% Cl: 0.75-1.77) and these results agreed with what had been reported by Tovbin et al 22…”

Accreta placentation: a systematic review of prenatal ultrasound imaging and grading of villous invasiveness

“…The terminology used to describe PA was diverse. Seven studies used the term "morbidly adherent placenta" 66,86,89,97,100,103,106 , two used "placental adhesive disorders" 70,101 , two used "abnormally invasive placentation" 92,104 , two used "abnormally adherent placenta" or "abnormal placental adherence" 79,83 , one use "advanced invasive placentation" 96 and one used the term "abnormal myometrial invasion". 61 Gray-scale ultrasound was used, and the corresponding data presented by all authors except one.…”

“…The 53 series included 24 prospective 58-62,65,66,70-72,76,80,83,85,89-91,93,98,101,102,105-107 and 29 retrospective studies with a total of 1078 cases of PA. All series except eight, which did not report data on previous surgical history 63,66,72,81,97,98,101,106 , included women presenting with placenta praevia and a history of CD and/or other uterine surgeries. In 21 series, including 568 cases of PA, the depth of villous invasiveness was not described.…”

“…A detailed description of the pathologic findings was available in 29 series. In 11 series, the pathologic examination was reported as performed but no data were provided 58,59,65,67,69,81,82,87,100,104,106 and in 12 series there was no histopathologic information. 20,56,68,75,85,90,91,95,96,98,99,103…”