Objective: Placenta accrete (PA) is a lack of decidual area between the placenta and miometrium, thus the trophoblast is directly facing the miometrium. The 88% of placenta accreta is associated with placenta praevia and it is the cause of 33-50% of all peripartum hysterectomies. The higher incidence of placenta praevia/accreta is due to an increased number of caesarean sections (CS), with an 8 times increased risk with two previous CS and a 2 time increased risk with one previous CS. Ultrasound (US) and color Doppler are used to diagnose PA. A correct diagnosis of placental accretism can improve maternal-fetal prognosis through an adequate planning of the delivery. The aim of the present study was to establish our echographic accuracy in the diagnosis of placental accretism. Methods: From January 2011 until December 2012 we prospectively analyzed 188 cases with a diagnosis of placenta praevia. We searched for the echographic criteria of placental accretism by 2D and 3D US and color-doppler after 24th weeks of gestation. Confirmation of placental accretism was histological or clinical (incomplete delivery of placenta and/or visible areas of accretism). Results: There were 28 cases of PA, 57% of which histologically diagnosed. US and color Doppler detected 78% of them, with a specificity of 99%. Sensitivity and specificity improved through the years: 76% (13/17) and 100% (80/80) respectively in 2011 and 82% (9/11) and 97% (78/80) respectively in 2012. In 2011, 11/17 (65%) diagnosed PA had an hysterectomy after CS and in 2012 5/11 (45%). Conclusions: We confirmed that echography is a good methodology in the diagnosis of placental accretism. Indeed, the knowledge of PA allowed planning of time and site of delivery thus improving outcomes.

Sensitivity and specificity of echography in the diagnosis of placental accretism in patients with diagnosis of placenta praevia

GAROFALO, GIULIA;PILLONI, Eleonora;GAGLIOTI, PIETRO;SOCHIRCA, OLGA;OBERTO, Manuela;PACE, Carlotta;OLEARO, Elena;ROLFO, Alessandro;TODROS, Tullia
2013-01-01

Abstract

Objective: Placenta accrete (PA) is a lack of decidual area between the placenta and miometrium, thus the trophoblast is directly facing the miometrium. The 88% of placenta accreta is associated with placenta praevia and it is the cause of 33-50% of all peripartum hysterectomies. The higher incidence of placenta praevia/accreta is due to an increased number of caesarean sections (CS), with an 8 times increased risk with two previous CS and a 2 time increased risk with one previous CS. Ultrasound (US) and color Doppler are used to diagnose PA. A correct diagnosis of placental accretism can improve maternal-fetal prognosis through an adequate planning of the delivery. The aim of the present study was to establish our echographic accuracy in the diagnosis of placental accretism. Methods: From January 2011 until December 2012 we prospectively analyzed 188 cases with a diagnosis of placenta praevia. We searched for the echographic criteria of placental accretism by 2D and 3D US and color-doppler after 24th weeks of gestation. Confirmation of placental accretism was histological or clinical (incomplete delivery of placenta and/or visible areas of accretism). Results: There were 28 cases of PA, 57% of which histologically diagnosed. US and color Doppler detected 78% of them, with a specificity of 99%. Sensitivity and specificity improved through the years: 76% (13/17) and 100% (80/80) respectively in 2011 and 82% (9/11) and 97% (78/80) respectively in 2012. In 2011, 11/17 (65%) diagnosed PA had an hysterectomy after CS and in 2012 5/11 (45%). Conclusions: We confirmed that echography is a good methodology in the diagnosis of placental accretism. Indeed, the knowledge of PA allowed planning of time and site of delivery thus improving outcomes.
2013
International Federation of Placenta Associations (IFPA) meeting 2013
Whistler, CANADA
11-14 settembre 2013
34
84
84
Placenta; Echography; placenta praevia
Garofalo, Giulia; Pilloni, Eleonora; Maria Grazia Alemanno, ; Gaglioti, Pietro; Andrea, Sciarrone; Sochirca, Olga; Oberto, Manuela; Michela Chiadò Flo...espandi
File in questo prodotto:
Non ci sono file associati a questo prodotto.

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2318/142953
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus ND
  • ???jsp.display-item.citation.isi??? 0
social impact