Accuracy of 2D Doppler ultrasound findings for the diagnosis of placenta accreta in pregnant women with risk factors
DOI:
https://doi.org/10.18597/rcog.3045Keywords:
Placenta accreta, Doppler ultrasound, obstetric and gynaecological diagnostic techniquesAbstract
Objective: To determine the accuracy of 2D ultrasound and Doppler ultrasound for the diagnosis of placenta accreta in pregnant women with risk factors when compared to clinical diagnosis.
Materials and methods: Study of diagnostic accuracy for the assessment of placenta accreta in high-risk patients who ended their pregnancy between 2014 and 2016 at Hospital Universitario de Santander. After obtaining their informed consent, 51 pregnant women over 18 years of age, more than 12 weeks of gestational age, low or anterior placenta or a history of uterine surgery were included. The diagnosis of a high probability of placenta accreta based on the presence of at least two ultrasound criteria and one Doppler criterion was compared with the gold standard of the visual finding during the cesarean section and of the surgical specimen in patients taken to hysterectomy, or during the clinical course in women with vaginal delivery. Sociodemographic and clinical variables are described, and the sensitivity and specificity, and positive or negative odds ratios are estimated.
Results: The diagnosis of high probability of placenta accreta based on 2D Doppler Ultrasound has a high sensitivity of 88.2% (95% CI: 70.0-100) and specificity of 97.1% (95% CI: 89,9-100), with positive LR of 30.0 (95% CI: 4.3-208.5) and negative LR of 0.12 (95% CI: 0.03-0.45).
Conclusions: The diagnosis of high probability of placenta accreta using non-invasive imaging provides valuable information regarding the presence and extent of placenta accreta in patients with known risk factors.Author Biographies
Wilmer Fabián Rangel-Carvajal
Departamento de Ginecología y Obstetricia, Escuela de Medicina, Facultad de Salud, Universidad Industrial de Santander, Bucaramanga (Colombia).
Luz Ángela Gutiérrez-Sánchez
Departamento de Ginecología y Obstetricia, Escuela de Medicina, Facultad de Salud, Universidad Industrial de Santander, Bucaramanga (Colombia). Unidad de Medicina Materno-fetal, Departamento de Ginecología y Obstetricia, Hospital Universitario de Santander, Bucaramanga (Colombia). luangusa@hotmail.com.
Luis Alfonso Díaz-Martínez
Escuela de Medicina, Facultad de Salud, Universidad Industrial de Santander, Bucaramanga (Colombia).
References
Hull AD, Resnik R. Placenta acreta. En: Creasy RK, Resnick R, editors. Maternal-Fetal Medicine: Principles and Practice. 6 ed. Philadelphia: Saunders; 2009.
Palacios-Jaraquemada JM. Diagnosis and management of placenta accreta. Best Prac Res Clin Obst Gynaecol. 2008;22:1133-48. https://doi.org/10.1016/j.bpobgyn.2008.08.003.
Anjum F, Bashir R, Rahim A. Maternal and foetal outcome in cases of placenta previa, accreta and increta. Ann King Edward Med Univ. 2016;22:296-300. https://doi.org/10.21649/akemu.v22i4.1469
Finberg HJ, Williams JW. Placenta accreta: Prospective diagnosis in patients with placenta previa and prior cesarean section. J Ultrasound Med. 1992;11:333-43. https://doi.org/10.7863/jum.1992.11.7.333.
Fitzpatrick KE, Sellers S, Spark P, Kurinczuk JJ, Brocklehurst P, Knight M. The management and outcomes of placenta accreta, increta, and percreta in the UK: A population-based descriptive study. BJOG. 2013;121:62-71. https://doi.org/10.1111/1471-0528.12405.
Bjurström J, Collins S, Langhoff-Ross J, Sundberg K, Jørgersen A, Duvekot JJ, et al. Failed manual removal of the placenta after vaginal delivery. Arch Gynecol Obstet. 2018;297:323-32. https://doi.org/10.1007/s00404-017-4579-2.
Jauniaux E, Chantraine F, Silver RM, Langhoff-Roos J. FIGO Placenta Accreta Diagnosis and Management Expert Consensus Panel: FIGO consensus guidelines on placenta accreta spectrum disorders: Epidemiology. Int J Gynecol Obstet. 2018;140:265-73. https://doi.org/10.1002/ijgo.12407.
Miller DA, Chollet JA, Goodwin TM. Clinical risk factors for placenta previa-placenta accreta. Am J Obstet Gynecol 1997;177:210-4. https://doi.org/10.1016/S0002-9378(97)70463-0.
FIGO Safe Motherhood and Newborn Health (SMNH) Committee. Prevention and treatment of postpartum hemorrhage in low-resource settings. Int J Gynecol Obstet. 2012;11:108-18.
Morlano M, Sarno L, Napolitano R, Capone A, Tessitore GM, Maruotti GM, et al. Placenta accreta: Incidence and risk factors in an area with a particularly high rate of cesarean section Maddalena Morlando. Acta Obstet Gynecol Scand. 2013;92:457-60. https://doi.org/10.1111/aogs.12080.
Silver RM, Landon MB, Rouse DJ, Leveno KJ, et al. Maternal morbidity associated with multiple repeat cesarean deliveries. Obstet Gynecol. 2006;107:1226-32. https://doi.org/10.1097/01.AOG.0000219750.79480.84.
Thurn L, Lindqvist PG, Jakobsson M, Colmom LB, Klugsoyr K, Bjarnadóttir RI, et al. Abnormally invasive placenta-prevalence, risk factors and antenatal suspicion: Results from a large population-based pregnancy cohort study in the Nordic countries. BJOG. 2016;123:1348-55. https://doi.org/10.1111/1471-0528.13547.
Jauniaux E, Bhide A. Prenatal ultrasound diagnosis and outcome of placenta previa accreta after cesarean delivery: A systematic review and meta-analysis. Am J Obstet Gynecol. 2017;217:27-36. https://doi.org/10.1016/j.ajog.2017.02.050.
Bhide A, Prefumo F, Moore J, Hollis B, Thilaganathan B. Placental edge to internal os distance in the late third trimester and mode of delivery in placenta previa. Br J Obstet Gynaecol. 2003;110:860-4. https://doi.org/10.1111/j.1471-0528.2003.02491.x.
Jauniaux E, Jurkovic D. Placenta accreta: Pathogenesis of a 20th century iatrogenic uterine disease. Placenta. 2012;33:244-51. https://doi.org/10.1016/j.placenta.2011.11.010.
Silver RM, Landon MB, Rouse DJ, Leveno KJ, Spong CY, Thom EA, et al. Maternal morbidity associated with multiple repeat cesarean deliveries. Obstet Gynecol. 2006;107:1226-32. https://doi.org/10.1097/01.AOG.0000219750.79480.84.
Goh WA, Zalud I. Placenta accreta: Diagnosis, management and the molecular biology of the morbidity adherent placenta. J Matern Fetal Neonatal Med. 2016;29:1795-800.
Sentilhes L, Kayem G, Chandraharan E, Palacios-Jaraquemada J, Jauniaux E, FIGO Placenta Accreta Diagnosis and Management Expert Consensus Panel. FIGO consensus guidelines on placenta accrete spectrum disorders: Conser vative management. Int J Gynecol Obstet. 2018;14:291-8. https://doi.org/10.1002/ijgo.12410.
Jauniaux E, Ayres-de-Campos D, FIGO Placenta Accreta Diagnosis and Management Expert Consensus Panel. FIGO consensus guidelines on placenta accrete spectrum disorders: Introduction. Int J Gynecol Obstet. 2018;140:261-4. https://doi.org/10.1002/ijgo.12406
Allen L, Jauniaux E, Hobson S, Papillon-Smith J, Belfort MA, FIGO Placenta Accreta Diagnosis and Management Expert Consensus Panel. FIGO consensus guidelines on placenta accreta spectrum disorders: Nonconservtive surgical management. Int J Gynecol Obstet. 2018;140:281-90. https://doi.org/10.1002/ijgo.12409
Chou MM, Ho ES, Lee YH. Prenatal diagnosis of placenta previa accreta by transabdominal color Doppler ultrasound. Ultrasound Obstet Gynecol. 2000;15:28-35. https://doi.org/10.1046/j.1469-0705.2000.00018.x.
Jauniaux E, Bhide A, Kennedy A, Woodward P, Hubinont C, Collins S, FIGO Placenta Accreta Diagnosis and Management Expert Consensus Panel. FIGO consensus guidelines on placenta accrete spectrum disorders: Prenatal diagnosis and screening. Int J Gynaecol Obstet. 2018;140:274-80. https://doi.org/10.1002/ijgo.12408.
Publications Committee, Society for Maternal-Fetal Medicine, Belfort MA. Placenta accreta. Am J Obstet Gynecol. 2010;203:430-9. https://doi.org/10.1016/j.ajog.2010.09.013.
Hamisa H, Mashaly E, Fathy S, Tawfeek A. Role of Doppler US and MRI in diagnosis of placenta accreta. Alexandria J Med. 2015;51:225-30. https://doi.org/10.1016/j.ajme.2014.09.002
Algebally AM, Yousef RR, Badr SS, Al Obeidly A, Szmigielski W, Al Ibrahim AA. The value of ultrasound and magnetic resonance imaging in diagnostics and prediction of morbidity in cases of placenta previa with abnormal placentation. Pol J Radiol. 2014;79:409-16. https://doi.org/10.12659/PJR.891252.
Calì G, Giambanco L, Puccio G, Forlani F. Morbidly adherent placenta: Evaluation of ultrasound diagnostic criteria and differentiation of placenta accreta from percreta. Ultrasound Obstet Gynecol. 2013; 41:406-12. https://doi.org/10.1002/uog.12385.
Comstock CH, Love JJ, Bronsteen RA, Lee W, Vettraino IM, Huang RR, et al. Sonographic detection of placenta accreta in the second and third trimesters of pregnancy. Am J Obstet Gynecol. 2004;190:1135-40. https://doi.org/10.1016/j.ajog.2003.11.024.
Wong HS, Cheung YK, Zucollo J, Tait J, Pringle KC. Evaluation of sonographic diagnostic criteria for placenta accreta. J Clin Ultrasound. 2008; 36:551-9. https://doi.org/10.1002/jcu.20524.
Yang JI, Lim YK, Kim HS, Chang KH, Lee JP, Ryu HS. Sonographic findings of placental lacunae and the prediction of adherent placenta in women with placenta previa totalis and prior Cesarean section. Ultrasound Obstet Gynecol. 2006;28:178-82. https://doi.org/10.1002/uog.2797.
Tolsgaard MG, Ringsted C, Dreisler E, Klemmensen A, Loft A, Sorensen JL, et al. Reliable and valid assessment of ultrasound operator competence in obstetrics and gynecology. Ultrasound Obstet Gynecol. 2014;43:437-43. https://doi.org/10.1002/uog.13198.
Ferreira FE, Angulo M. Predicción del acretismo placentario con ultrasonido Doppler en el Hospital Universitario de Neiva, estudio de cohorte. Rev Colomb Obstet Ginecol. 2007;58:290-5.
Parra G, Díaz I, Serrano S, Vergara F, de Nubbila E. Acretismo placentario: diagnóstico prenatal mediante ultrasonido y resonancia magnética y su correlación histopatológica en Barranquilla (Colombia). Rev Colomb Obstet Ginecol. 2009;60:281-5.
Vargas IJ, Gutiérrez LA, Herrera M. Evaluación características operativas: ecografía 2D y Doppler color para diagnóstico de acretismo placentario, Clínica Universitaria Colombia, Bogotá. Universidad Colegio Mayor de Nuestra Señora del Rosario. 2012 [visitado 2016 Dic 22]. Disponible en: http://repository.urosario.edu.co/bitstream/handle/10336/2773/72245548-012.pdf?sequence=1&isAllowed=y
Ayati S, Leila L, Pezeshkirad M, Seilanian Toosi F, Nekooei S, Shakeri MT, et al Accuracy of color Doppler ultrasonography and magnetic resonance imaging in diagnosis of placenta accreta: A survey of 82 cases. Int J Reprod Biomed (Yazd). 2017;15:225-30. https://doi.org/10.29252/ijrm.15.4.225.
D'Antonio F, Iacovella C, Vhide A. Prenatal identification of invasive placentation using ultrasound: Systematic review and meta-analysis. Ultrasound Obstet Gynecol. 2013;42:509-17. https://doi.org/10.1002/uog.13194.
Luke RK, Sharpe JW, Greene RR. Placenta accreta: The adherent or invasive placenta. Am J Obstet Gynecol. 1966;95:660-8. https://doi.org/10.1016/S0002-9378(16)34741-X.
Gielchinsky Y, Rojansky N, Fasouliotis SJ, Ezra Y. Placenta accreta—summary of 10 years: A survey of 310 cases. Placenta. 2002;23:210-4. https://doi.org/10.1053/plac.2001.0764.
Parra-Herrán C, Djordjevic B. Histopathology of placenta creta: Chorionic villi intrusion into myometrial vascular spaces and extravillous trophoblast proliferation are frequent and specific findings with implications for diagnosis and pathogenesis. Int J Gynecol Pathology. 2015;35:497-508. https://doi.org/10.1097/PGP.0000000000000250.
Riteau A, Tassin M, Chambon G, Le Vaillant C, de Laveaucoupet J, et al. Accuracy of ultrasonography and magnetic resonance imaging in the diagnosis of placenta accreta. PloS One. 2014; 9:e94866. https://doi.org/10.1371/journal.pone.0094866.
Tantbirojn P, Crum CP, Parast MM. Pathophysiology of placenta creta: the role of decidua and extravillous trophoblast. Placenta. 2008;29:639-45. https://doi.org/10.1016/j.placenta.2008.04.008.
How to Cite
Downloads
Downloads
Published
Issue
Section
License
Copyright (c) 2018 Revista Colombiana de Obstetricia y Ginecología
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
| Article metrics | |
|---|---|
| Abstract views | |
| Galley vies | |
| PDF Views | |
| HTML views | |
| Other views | |
