Predicting placenta accreta with Doppler ultrasound at the Neiva teaching hospital, Colombia. A cohort study
DOI:
https://doi.org/10.18597/rcog.439Keywords:
placenta accreta, placenta previa, hysterectomy, Doppler ultrasonographyAbstract
Objective: evaluating ultrasonographic findings and maternal and perinatal outcomes for patients with and without accretism who were submitted to antenatal ultrasonographies and Doppler ultrasound.
Methods: a cohort of high-risk women was studied for accretism. Foetal Doppler results were compared with outcomes after surgery, the need for hysterectomy, perinatal outcome and clinical evolution following surgery.
Results: a total of 51 patients having a high risk of accretism were evaluated. High-probability for accretism was confirmed in 5 patients, whereas low probability was found for 46 patients. Comparing the results in terms of the presence of accretism, there was a 60% hysterectomy rate for the high probability group whereas it was only 2% in the low-probability group. Blood transfusions were necessary in 40% of patients having high-risk of accretism, whereas it was only 2% in the low-probability grup.
Conclusions: maternal and neonatal complications are more frequent in patients having a high probability of accretism. Prenatal diagnosis of placenta accreta is essential in detecting patients at risk of maternal complications and determining the need for hysterectomy following a caesarean section.
Author Biographies
Fidel Ernesto Ferreira Narváez
Mónica Angulo Carvallo
References
Oyelese Y, Smulian JC. Placenta previa, placenta accreta, and vasa previa. Obstet Gynecol 2006;107:927-41.
Miller DA, Chollet JA, Goodwin TM. Clinical risk factors for placenta previa-placenta accreta. Am J Obstet Gynecol 1997;177:210-4.
Warshak CR, Eskander R, Hull AD, Scioscia AL, Mattrey RF, Benirschke K, et al. Accuracy of ultrasonography and magnetic resonance imaging in the diagnosis of placenta accreta. Obstet Gynecol 2006;108:573-81.
Clark SL, Koonings PP, Phelan JP. Placenta previa/accreta and prior cesarean section. Obstet Gynecol 1985;66:89-92.
Chou MM, Tseng JJ, Ho ES, Hwang JI. Three dimensional color power Doppler imaging in the assessment of uteroplacental neovascularization in placenta previa increta/percreta. Am J Obstet Gynecol 2001;185:1257-60.
Comstock CH, Love JJ Jr, 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.
O’Brien JM, Barton JR, Donaldson ES. The management of placenta percreta: conservative and operative strategies. Am J Obstet Gynecol 1996;175:1632-8.
Clark SL. Placenta previa and abruptio placentae. En: Creasy RK, Resnik R (eds.). Maternal-fetal medicine: principles and practice. 5th ed. Philadelphia: Saunders; 2004. p.707-22.
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.
Rojas-Losada F, Kuzmar-Daza L, Ferreira-Narváez F, Abdalla M. Diagnóstico y manejo quirúrgico de placenta accreta. Presentación de un caso y revisión de la literatura. Rev Colomb Obstet Ginecol 2006;57:123-8.
Guy GP, Peisner DB, Timor-Tritsch IE. Ultrasonographic evaluation of uteroplacental blood flow patterns of abnormally located and adherent placentas. Am J Obstet Gynecol 1990;163:723-7.
Hudon L, Belfort M, Broome D. Diagnosis and management of placenta percreta: a review. Obstet Gynecol Surv 1998;53:509-17.
Comstock CH. Antenatal diagnosis of placenta accreta: a review. Ultrasound Obstet Gynecol 2005;26:89-96.
Chou MM, Ho ES, Lee YH. Prenatal diagnosis of placenta previa accreta by transabdominal color Doppler ultrasound. Ultrasound Obstet Gynecol 2000;15:28-35.
Finberg HJ, Williams W. Placenta accreta: prospective sonographic diagnosis in patients with placenta previa and prior cesarean section. J Ultrasound Med 1992;11:333-43.
Hoffman-Tretin F, Koenigsberg M, Rabin A, Anyaegbunam A. Placenta accreta. Additional sonographic obser vations. J Ultrasound Med 1992;11:29-34.
Levine D, Hulka CA, Ludmir J, Li W, Edelman RR. Placenta accreta: evaluation with color Doppler US, power Doppler US and MR imaging. Radiology 1997;205:773-6.
Perucca E, Cazenave H, Barra A, Ochoa N, Villagrán G, Espinoza R, et al. Placenta previa percreta con invasión vesical. Rev Chil Obstet Ginecol 2002;67:364-7.
Thorp JM, Councell RB, Sandridge DA, Wiest HH. Antepartum diagnosis of placenta previa percreta by magnetic resonance imaging. Obstet Gynecol 1992;80:506-8.
Catanzarite V, Stanco L, Schrimmer DR, Conroy C. Managing placenta previa/accreta. Contemp Obstet Gynecol 1996;41:66-95.
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