Use of Magnetic Resonance Imaging and Ultrasound in the Antenatal Diagnosis of Placenta Accreta

Lam, Gattett; Kuller, Jeffrey A.; McMahon, Michael

doi:10.1177/107155760200900108

Cited by 87 publications

(56 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Although there still appears to be a difference of opinion in the literature regarding the accuracy of ultrasound for the diagnosis of placenta accrete. With the exception of the Lam study who reports a sensitivity of 33% [14], all other studies report a sensitivity of 77% -93% [14] [15]. Morbidity from placenta accreta is caused by problems associated with massive bleeding.…”

Section: Discussionmentioning

confidence: 96%

Outcome of Patients with Placenta Accreta at El Shatby Maternity University Hospital

AbdElfatah¹,

Awad²,

Abd-Eldaym³

et al. 2017

OJOG

View full text Add to dashboard Cite

Objective: The aim of this study was to determine the incidence, risk factors, and outcomes of management of patients with placenta accreta. Background Placenta accreta occurs when the placental implantation is abnormal. The marked increase in incidence has been attributed to the increasing prevalence of cesarean delivery in recent years. The most common theory is defective decidualization. The most important risk factor for placenta accreta is placenta previa after a prior cesarean delivery. The first clinical manifestation of placenta accreta is usually profuse, life-threatening hemorrhage. The recommended management of suspected placenta accreta is planned preterm cesarean hysterectomy with the placenta left in situ. Patients and methods: It's a study of all cases of placenta accreta at El-Shatby Maternity University Hospital starting from 1/4/2016 till 1/10/2016. Selection of the cases will only be dependent upon their pregnancy gestational age above 28 weeks of gestation. Results: The incidence of placenta accreta was 1/75 cesarean deliveries. The ultrasonography and doppler had a false negative rate of 54.6% and a sensitivity of 45.2% in diagnosis of placenta accreta. The rate of blood transfusion was 79.6%. Uterine preserving procedures performed in 66%. Cesarean hysterectomy performed in 34%. Intensive care unit admission occurred in 27.3%. The mean gestational age at delivery was 33.8 ± 4.6 weeks' gestation. 31.8% admitted to the neonatal intensive care unit. Conclusion: The incidence of placenta accreta increased due to the increasing rate of cesarean deliveries, prenatal diagnosis of placenta accreta is paramount, as most women are asymptomatic. Prenatal diagnosis allows time for a multidisciplinary team to make delivery plans, which will help decrease surgical complications.

show abstract

Section: Discussionmentioning

confidence: 96%

Outcome of Patients with Placenta Accreta at El Shatby Maternity University Hospital

AbdElfatah¹,

Awad²,

Abd-Eldaym³

et al. 2017

OJOG

View full text Add to dashboard Cite

show abstract

“…A positive predictive value of 78% and a negative predictive value of 94% has been reported by Finberg et al, but some of other authors suggested that sonography might detect only around 33% of cases of placenta accreta/increta. 11,12 Regarding treatment, hysterectomy is probably the best option for long-term outcome, as previously reported. 13 Numbers of attempts have been made to treat placenta increta with various drugs to allow the pregnancy to continue.…”

Section: Discussionmentioning

confidence: 71%

Case report on placenta accreta presenting obstetric emergency

Kaur¹

2017

Int J Reprod Contracept Obstet Gynecol

View full text Add to dashboard Cite

Placenta accreta is a potentially life-threatening obstetric condition that requires a multidisciplinary approach to management. As the incidence of Caesarean have increased, Placenta accreta also has increased and considered as an important cause of maternal and fetal/neonatal morbidity and mortality. Although multiple caesarean deliveries are at the largest risk factor for the placenta accreta, increasing maternal age and parity, as well as other uterine surgeries are also important. In Patient at risk for accreta, obstetrical ultrasonography performed by an experienced provider should be obtained. A multidisciplinary team in a centre with expertise in managing placenta accreta should care for case of suspected accreta.

show abstract

“…Entretanto, ainda não existem critérios para a RM 2,4 . A RM, nos últimos dez anos, se destaca como método de diagnóstico antenatal de malformações complexas e de patologias maternas na gestação, devido a não exposição à radiação ionizante e à boa resolução diagnóstica 5 .…”

Section: Introductionunclassified

“…A RM, nos últimos dez anos, se destaca como método de diagnóstico antenatal de malformações complexas e de patologias maternas na gestação, devido a não exposição à radiação ionizante e à boa resolução diagnóstica 5 . Já existem evidências na literatura de que a RM tem um papel importante no auxílio da detecção e complementa a avaliação da extensão do acretismo e do percretismo placentário; no entanto, estes estudos são limitados, pois as análises são retrospectivas e há grande variabilidade técnica 4,5 . Os critérios clínicos para suspeita de acretismo placentário foram: multiparidade, cesáreas (mais que duas), placenta prévia, placentas corporais anteriores, miomectomias e manipulações cirúrgicas prévias do útero.…”

Section: Introductionunclassified

Valor da ressonância magnética no diagnóstico antenatal do acretismo placentário

Francisco¹,

Goldman²,

Faria³

et al. 2006

Rev. Bras. Ginecol. Obstet.

View full text Add to dashboard Cite

RESUMOObjetivos: estabelecer os principais sinais de acretismo placentário na ressonância magnética (RM) em gestantes com suspeita clínica e avaliar a utilidade do método. Métodos: estudo prospectivo, transversal em 15 pacientes com suspeita de acretismo placentário. O período compreendido foi de março de 2003 a fevereiro de 2006. A idade gestacional variou de 20 a 31 semanas. Todas as pacientes realizaram RM com estudo dirigido para placenta e haviam sido submetidas à ultra-sonografi a (US) prévia ao exame. Todas as peças foram encaminhadas para estudo anátomo-patológico (AP). Os exames foram realizados nos equipamentos Magnetom Impact e Sonata Maestro Class Siemens ® , adquiridas as seqüências HASTE, TURBO FISP, nos planos axial, sagital e coronal e gradiente echo (GE ® ) pré-e pós-contraste dinâmico no melhor plano de aquisição. A análise das imagens foi realizada por dois radiologistas em consenso. Resultados: a idade gestacional média das pacientes foi de 24,3 semanas. Foram estudadas sete placentas prévias centro-totais (47%), seis placentas corporais anteriores (40%) e duas placentas corporais posteriores (13%). A US foi positiva em 80% dos casos e a RM em 53% dos casos. No entanto, a US apresentou concordância fraca com o AP pelo teste de kappa (11%), com sensibilidade de 75%, especifi cidade de 14%, valor preditivo positivo (VPP) de 50% e valor preditivo negativo (VPN) de 33%. Já a RM teve concordância excelente com o AP (0,86), com sensibilidade de 100%, especifi cidade de 86% , VPP de 89% e VPN de 100%. Conclusões: a RM é útil na identifi cação do acretismo placentário. Os principais sinais na RM do acretismo placentário são: o hipersinal transmural, a descontinuidade da parede miometrial nas seqüências rápidas e a identifi cação dos vasos invadindo o miométrio nas seqüências dinâmicas. PALAVRAS-CHAVE:Placenta acreta/diagnóstico; Imagem por ressonância magnética ABSTRACT Purpose: to establish the main signs of placental accretism in magnetic resonance imaging (MRI) in patients with clinical suspicion and to estimate the benefi t of this method. Methods: prospective transversal study with 15 patients suspected of placental accretism, referred between March 2003 and February 2006. Gestational age varied from 20 to 31 weeks. All patients underwent MRI to study the placenta and had previously done an ultrasonography. Material was sent to histological study. MRI was done on Magnetom Impact and Sonata Maestro Class Siemens ® , with acquired sequences HASTE, TURBO SPIN in axial, sagittal, coronal planes and echo gradient (GE ® ), pre-and post-dynamic contrast in the best plan for acquisition. Images were analyzed by a team of two radiologists. Results: mean gestational age was 24.3 weeks. We studied seven placenta previa (47%), six anterior placentas (40%) and two posterior placentas (13%). Ultrasonography was positive in 80% of the palcentas and MRI in 53%. However, echography had a low concordance with anatomic pathological studies by Kappa test (11%), revealing 75% of sensitivity, 14% of specifi city, 50%...

show abstract

Use of Magnetic Resonance Imaging and Ultrasound in the Antenatal Diagnosis of Placenta Accreta

Abstract: Both MRI and US had poor predictive value in the diagnosis of placenta accreta, and further refinement in the techniques of both MRI and US is needed for these tests to be used to reliably diagnose these pathologic conditions.

Cited by 87 publications

References 7 publications

Outcome of Patients with Placenta Accreta at El Shatby Maternity University Hospital

Outcome of Patients with Placenta Accreta at El Shatby Maternity University Hospital

Case report on placenta accreta presenting obstetric emergency

Valor da ressonância magnética no diagnóstico antenatal do acretismo placentário

Contact Info

Product

Resources

About