OC02.02: *Screening for placenta accreta spectrum in Canada in early pregnancy: analysis of retrospectively deemed high‐risk women candidates for screening

The Australasian Diabetes in Pregnancy Society recommends screening high-risk women for gestational diabetes mellitus (GDM) before 24 weeks gestation, under the assumption that an earlier diagnosis and opportunity to achieve normoglycemia will minimize adverse outcomes. However, little evidence exists for this recommendation. The study objective was to compare the pregnancy outcomes of high-risk women diagnosed with GDM before 24 weeks gestation and routinely diagnosed women after 24 weeks gestation. A retrospective audit was conducted of all pregnancies diagnosed with GDM using International Association of Diabetes and Pregnancy Study Groups criteria over 12 months at a tertiary Australian hospital. Adverse perinatal outcomes were compared between “Early GDM” diagnosed before 24 weeks (n=133) and “Late GDM” diagnosed from 24 weeks (n=636). Early GDM had a significantly lower newborn composite outcome frequency (hypoglycemia, birth trauma, NICU/SCN admission, stillbirth, neonatal death, respiratory distress, and phototherapy) compared to Late GDM (20.3% vs. 30.0%, p=0.02). Primary cesarean, hypertensive disorders, postpartum hemorrhage, birthweight >90th percentile, macrosomia, and preterm birth frequencies were not significantly different between groups. Therefore, high-risk women diagnosed with GDM in early pregnancy were not more likely to have an adverse outcome compared to routinely diagnosed women. As they are a high-risk group, this may indicate a possible benefit to the early diagnosis of GDM.

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OC08.02: Outcomes of pregnancies at high risk for placenta accreta spectrum following negative diagnostic imaging

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.22254 ◽

2020 ◽

Vol 56 (S1) ◽

pp. 23-23

Author(s):

M. Genc ◽

C. Reeder ◽

K.R. Sylvester‐Armstrong ◽

E. Wert ◽

L. Silva

Keyword(s):

High Risk ◽

Diagnostic Imaging ◽

Placenta Accreta ◽

Placenta Accreta Spectrum

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Scoring Model for Prediction of Placenta Accreta Spectrum (PAS) in Early Pregnancy

Evidence Based Women s Health Journal ◽

10.21608/ebwhj.2021.58921.1119 ◽

2021 ◽

Vol 0 (0) ◽

pp. 0-0

Author(s):

Hassan Kamel ◽

Diaa Eldeen Abd El Aal ◽

Mohammed Nagy Elammary ◽

Mohammed Twfik

Keyword(s):

Early Pregnancy ◽

Placenta Accreta ◽

Scoring Model ◽

Placenta Accreta Spectrum

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Significance of the routine first-trimester antenatal screening program for aneuploidy in the assessment of the risk of placenta accreta spectrum disorders

Journal of Perinatal Medicine ◽

10.1515/jpm-2019-0261 ◽

2019 ◽

Vol 48 (1) ◽

pp. 21-26

Author(s):

Grigory A. Penzhoyan ◽

Tatiana B. Makukhina

Keyword(s):

High Risk ◽

Blood Loss ◽

Pregnant Women ◽

Placenta Accreta ◽

Screening Program ◽

First Trimester ◽

Significant Difference ◽

Placenta Accreta Spectrum ◽

Spectrum Disorders ◽

Β Hcg

AbstractObjectiveTo select a group at high risk of placenta accreta spectrum disorders (PAS) based on the data of serum screening in the first trimester.MethodsA retrospective analysis of 48 patients with abnormal placental location (AP), including placenta previa (PP) only (n = 23) and PP and PAS (n = 25), was performed. Additionally, the AP group was divided depending on the blood loss volume: not higher than 1000 mL (LBL) (n = 29) and higher than 1000 mL (HBL) (n = 19); diagnostic term of PAS by ultrasound, data pregnancy-associated plasma protein-A (РAРР-A) and free β subunit of human chorionic gonadotropin (free β-hCG) multiple of median (MоM) at 11+0–13+6 weeks of gestation were evaluated. Serological markers were compared with the data of 39 healthy pregnant women with scar after previous cesarean section and normal placental location (control).ResultsThe mean gestation at diagnostic term of PAS was 29 weeks. PAPP-Р MоM [mean (M) ± standard deviation (SD)] was: in controls, 1.07 ± 0.47; in the AP group, 1.59 ± 0.24; in PP, 1.91 ± 1.52; in PAS, 1.30 ± 0.85; in LBL, 1.37 ± 1.20; in HBL, 1.91 ± 1.24. The difference between control/AP, control/PP, control/PAS, PP/PAS, control/LBL, control/HBL and LBL/HBL was Р = 0.256, 0.145, 0.640, 0.311, 0.954, 0.025 and 0.09, respectively. Free β-hCG MoM (M ± SD) was: in controls, 1.08 ± 0.69, in AP, 1.31 ± 0.96; in PP, 1.46 ± 0.19; in PAS, 1.16 ± 0.65; in LBL, 1.30 ± 0.06; in HBL, 1.32 ± 0.78. Comparison of free β-hCG AP with controls and between subgroups did not reveal a significant difference.ConclusionUnderestimation of PAS risk factors in pregnant women with AP leads to late diagnostics of pathology only in the third trimester. The assessment of the РAРР-A level in the first trimester may be helpful for the early prognosis of pathological blood loss at delivery for pregnant women with AP and for forming the high-risk group for PAS.

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