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Screening for morbidly adherent placenta in early pregnancy.
- Source :
-
Ultrasound in Obstetrics & Gynecology . Jan2019, Vol. 53 Issue 1, p101-106. 6p. - Publication Year :
- 2019
-
Abstract
- <bold>Objective: </bold>To estimate the diagnostic accuracy of a two-stage strategy for early prediction of morbidly adherent placenta (MAP). In the first stage, at 11-13 weeks' gestation, women with low-lying placenta and history of uterine surgery are classified as being at high risk for MAP and, in the second stage, at 12-16 weeks, these high-risk pregnancies are assessed at a specialist MAP clinic.<bold>Methods: </bold>This was a prospective study in women having an ultrasound scan at 11-13 weeks' gestation as a part of routine pregnancy care. Women with low-lying placenta and a history of uterine surgery were followed up at a specialist MAP clinic at 12-16 weeks' gestation, 20-24 weeks and 28-34 weeks. At each visit to the MAP clinic, an ultrasound scan was carried out and the following features suggestive of MAP were recorded: non-visible Cesarean section scar; bladder wall interruption; thin retroplacental myometrium; presence of intraplacental lacunar spaces; presence of retroplacental arterial-trophoblastic blood flow; and irregular placental vascularization demonstrated by three-dimensional power Doppler.<bold>Results: </bold>Screening at 11-13 weeks was carried out in 22 604 singleton pregnancies, 1298 (6%) of which were considered to be at high risk of MAP because they had previous uterine surgery and low-lying placenta. At the MAP clinic at 12-16 weeks, the diagnosis of MAP was suspected in 14 cases and this was confirmed at delivery in 13. In the rest of the population, there were no cases of MAP.<bold>Conclusion: </bold>Accurate prediction of MAP can be achieved by ultrasound examination at 12-16 weeks' gestation. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd. [ABSTRACT FROM AUTHOR]
- Subjects :
- *COMPARATIVE studies
*FETAL ultrasonic imaging
*LONGITUDINAL method
*RESEARCH methodology
*EVALUATION of medical care
*MEDICAL cooperation
*PLACENTA diseases
*PREGNANCY
*FIRST trimester of pregnancy
*PREGNANCY complications
*RESEARCH
*UTERINE rupture
*EVALUATION research
*PREDICTIVE tests
*DIAGNOSIS
Subjects
Details
- Language :
- English
- ISSN :
- 09607692
- Volume :
- 53
- Issue :
- 1
- Database :
- Academic Search Index
- Journal :
- Ultrasound in Obstetrics & Gynecology
- Publication Type :
- Academic Journal
- Accession number :
- 133916831
- Full Text :
- https://doi.org/10.1002/uog.20104