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Journal of Ultrasound in Medicine :... Jul 2018
Topics: Adult; Cervix Uteri; Cesarean Section; Conization; Female; Follow-Up Studies; Humans; Hysterectomy; Magnetic Resonance Imaging; Patient Discharge; Placenta Accreta; Placenta Previa; Postpartum Hemorrhage; Pregnancy; Treatment Outcome; Ultrasonography, Prenatal
PubMed: 29280171
DOI: 10.1002/jum.14532 -
Clinical Obstetrics and Gynecology Dec 2018Predelivery diagnosis of placenta accreta, increta, and percreta (from here referred to as placenta accreta, unless otherwise noted) has increasingly created... (Review)
Review
Predelivery diagnosis of placenta accreta, increta, and percreta (from here referred to as placenta accreta, unless otherwise noted) has increasingly created opportunities to optimize antenatal management. Despite the increased frequency of placenta accreta today, occurring in as many as 1 in 533 to 1 in 272 deliveries, high-quality data are lacking for many aspects of antenatal management. This chapter will discuss antenatal management of, and risks faced by, women with suspected placenta accreta, a condition that most frequently requires a potentially morbid cesarean hysterectomy.
Topics: Adult; Blood Transfusion; Cesarean Section; Disease Management; Female; Gestational Age; Humans; Hysterectomy; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases; Placenta Accreta; Postpartum Hemorrhage; Pregnancy; Prenatal Care; Time Factors
PubMed: 30204620
DOI: 10.1097/GRF.0000000000000394 -
Placenta Aug 2022MRI has demonstrated its potential in the diagnosis of placenta percreta. Texture analysis is a novel technique to quantify tissue heterogeneity. The study aimed to... (Observational Study)
Observational Study
INTRODUCTION
MRI has demonstrated its potential in the diagnosis of placenta percreta. Texture analysis is a novel technique to quantify tissue heterogeneity. The study aimed to evaluate the feasibility of using texture analysis based on myometrium-derived T2WI to differentiate placenta accreta from increta.
METHODS
Participants with MRI and clinical or histopathological diagnosis of placenta increta were retrospectively enrolled. Texture analysis of T2WI was implemented on normal myometrium and placenta increta by MaZda software. With the Fisher discriminant method, parameter selection and reduction were done automatically. Multivariate analysis was used for the comparison of response variables between two groups. The contours of multivariable average vectors were compared using profile analysis. Two-step clustering was performed to assess the importance of parameters.
RESULTS
There were a total of 23 participants (median age 29 years, range 22-43 years). The pixel intensity distribution was narrow and wide in two first-order histograms taken from normal myometrium and placenta increta, respectively. Multivariate analysis showed nine second-order parameters derived from the histogram were statistically significant (P < 0.05). The results of two-step clustering indicated that three second-order parameters (Mean, Percentile 90%, and Percentile 99%) were important (predictor importance > 0.8). Multivariate analysis of three second-order parameters further showed they were different between normal myometrium and placenta increta.
DISCUSSION
Texture analysis based on myometrium-derived T2WI may be a useful add-on to MRI in diagnosing placenta increta.
TRIAL REGISTRATION
Registration number: ChiCTR2000038604 and name of registry: Evaluation of diagnostic accuracy of MRI multi-parameter imaging combined with texture analysis for placenta accreta spectrum disorders (PAD).
Topics: Adult; Female; Humans; Magnetic Resonance Imaging; Myometrium; Placenta; Placenta Accreta; Pregnancy; Retrospective Studies; Young Adult
PubMed: 35738112
DOI: 10.1016/j.placenta.2022.06.002 -
The Journal of Obstetrics and... Jan 2022Cesarean scar pregnancy (CSP) is a rare form of ectopic pregnancy, which is a long-term complication of cesarean section. Prompt and accurate diagnosis of CSP is... (Review)
Review
Cesarean scar pregnancy (CSP) is a rare form of ectopic pregnancy, which is a long-term complication of cesarean section. Prompt and accurate diagnosis of CSP is important to decrease maternal mobility and mortality. However, it is difficult to make an early detection for CSP complicated with morbidly adherent placenta. Contrast-enhanced ultrasound with the advantage in blood flow imaging is low-cost, time-saving, safe and more accessible in clinical practice. Here, we report a case with early detection of CSP with placenta increta by contrast-enhanced ultrasound and its successful uterine-sparing surgical management.
Topics: Cesarean Section; Cicatrix; Female; Humans; Placenta Accreta; Pregnancy; Pregnancy Trimester, First; Pregnancy, Ectopic
PubMed: 34655263
DOI: 10.1111/jog.15072 -
Asian Journal of Surgery Dec 2022
Topics: Pregnancy; Female; Humans; Placenta Accreta; Cesarean Section; Hysterectomy; Upper Extremity
PubMed: 35732540
DOI: 10.1016/j.asjsur.2022.06.049 -
Archives of Gynecology and Obstetrics Sep 2022The study aimed to investigate the potential risk factors for the placenta accreta spectrum (PAS), determine the predictive value of a diagnostic model, and evaluate the...
BACKGROUND
The study aimed to investigate the potential risk factors for the placenta accreta spectrum (PAS), determine the predictive value of a diagnostic model, and evaluate the effects of octamethylcyclotetrasiloxane (OMCTS) on trophoblast proliferation and migration.
METHODS
This case-control study included 244 pregnant women with PAS and 327 normal pregnant women who visited Guangzhou Women and Children's Medical Centre, China, from January 2014 to December 2017. Blood was collected from 42 women with PAS and 77 controls, and plasma specimens were analyzed by gas chromatography-time-of-flight mass spectrometry. In addition, the proliferation and migration of trophoblast cells were examined after treatment with OMCTS.
RESULTS
We found an association between the risk of PAS and clinical factors related to fasting blood glucose levels (BS0, OR = 5.78), as well as factors related to endometrial injury [history of cesarean section (OR = 179.59), uterine scarring (OR = 68.37), and history of abortion (OR = 5.66)]. Equally important, pregnant women with PAS had significantly higher plasma OMCTS concentrations than controls. In vitro, we found that OMCTS could promote the proliferation and migration of HTR8/SVneo cells. The model of combining clinical factors and OMCTS had a good performance in PAS prediction (AUC = 0.97, 95% CI 0.78-0.93).
CONCLUSIONS
The early diagnosis of PAS in pregnant women requires assessing risk factors, metabolic status, and BS0 levels before 20 weeks of gestation. OMCTS may be related to the development of PAS by promoting trophoblast cell proliferation and migration.
Topics: Case-Control Studies; Cesarean Section; Child; Female; Humans; Placenta; Placenta Accreta; Placenta Previa; Pregnancy; Retrospective Studies; Risk Factors; Siloxanes
PubMed: 34820720
DOI: 10.1007/s00404-021-06335-w -
Seminars in Perinatology Oct 2013Morbidly adherent placenta, which describes placenta accreta, increta, and percreta, implies an abnormal implantation of the placenta into the uterine wall. The... (Review)
Review
Morbidly adherent placenta, which describes placenta accreta, increta, and percreta, implies an abnormal implantation of the placenta into the uterine wall. The incidence of placenta accreta has increased significantly over the past several decades, with the main risk factors include prior cesarean section and placental previa. Sonographic markers of placenta accreta can be present as early as the first trimester and include a low uterine implantation of a gestational sac, multiple vascular lacunae within the placenta, loss of the normal hypoechoic retroplacental zone, and abnormality of the uterine serosa-bladder interface, among others. Ultrasound has high sensitivity and specificity for the diagnosis of placenta accreta and MRI should be reserved for rare cases in which the ultrasound is non-diagnostic. The optimum time for planned delivery for a patient with placenta accreta is around 34-35 weeks following a course of corticosteroid injection. The successful management of placenta accreta includes a multidisciplinary care team approach with the successful management relying heavily on the prenatal diagnosis of this entity and preparing for the surgical management in a multidisciplinary approach by assuring the most skilled team is available for those patients.
Topics: Cesarean Section; Female; Humans; Infant, Newborn; Placenta Accreta; Pregnancy; Ultrasonography, Prenatal
PubMed: 24176160
DOI: 10.1053/j.semperi.2013.06.014 -
Journal of Medical Case Reports Sep 2021Placenta accreta is known to be associated with significant maternal morbidity and mortality-primarily due to intractable bleeding during abortion or delivery at any...
BACKGROUND
Placenta accreta is known to be associated with significant maternal morbidity and mortality-primarily due to intractable bleeding during abortion or delivery at any level of gestation. The complications could be reduced if placenta accreta is suspected in a patient with a history of previous cesarean delivery and the gestational sac/placenta is located at the lower part of the uterus. Then, a proper management plan can be instituted, and complications can be reduced. The diagnosis of placenta accreta in the first trimester of pregnancy is considered uncommon.
CASE PRESENTATION
A 34-year-old Malay, gravida 4, para 3, rhesus-negative woman was referred from a private hospital at 13 weeks owing to accreta suspicion for further management. She has a history of three previous lower-segment cesarean sections. She also had per vaginal bleeding in the early first trimester, which is considered to indicate threatened miscarriage. Transabdominal ultrasound revealed features consistent with placenta accreta spectrum. She was counseled for open laparotomy and hysterectomy because of potential major complication if she continued with the pregnancy. Histopathological examination revealed placenta increta.
CONCLUSION
A high index of suspicion of placenta previa accreta must be in practice in a patient with a history of previous cesarean deliveries and low-lying placenta upon ultrasound examination during early gestation.
Topics: Abortion, Threatened; Adult; Cesarean Section; Female; Humans; Mothers; Placenta Accreta; Pregnancy; Pregnancy Trimester, First
PubMed: 34493340
DOI: 10.1186/s13256-021-03030-x -
Ginekologia Polska Nov 1970
Topics: Adult; Female; Humans; Placenta Accreta; Pregnancy; Uterine Rupture
PubMed: 5487532
DOI: No ID Found -
Journal of Pediatric and Adolescent... Feb 2022We present a rare case of pregnancy and invasive placentation in a unruptured, noncommunicating rudimentary uterine horn at 20 weeks' gestation.
BACKGROUND
We present a rare case of pregnancy and invasive placentation in a unruptured, noncommunicating rudimentary uterine horn at 20 weeks' gestation.
CASE
The patient was followed with ultrasound throughout early pregnancy and initial imaging for dating purposes showed a pregnancy within a communicating right horn of the uterus. At the 18-week anatomy ultrasound, the pregnancy was discovered to be within the noncommunicating, rudimentary left horn of the uterus. This was confirmed using pelvic magnetic resonance imaging. The patient opted for surgical management and subsequently underwent laparotomy and removal of the noncommunicating uterine horn and pregnancy. Placental tissue was adherent to the level of the serosa during surgery and pathologic diagnosis was significant for a placenta increta.
SUMMARY AND CONCLUSION
The patient recovered well from surgery and subsequently went on to have a successful term pregnancy delivered via cesarean section for breech in the right horn 15 months later.
Topics: Cesarean Section; Female; Humans; Placenta; Placenta Accreta; Pregnancy; Ultrasonography; Uterus
PubMed: 34389462
DOI: 10.1016/j.jpag.2021.08.003