Risk factors and clinical outcomes for placenta accreta spectrum with or without placenta previa

2021 ◽  
Author(s):  
Kohei Ogawa ◽  
Seung Chik Jwa ◽  
Naho Morisaki ◽  
Haruhiko Sago
Keyword(s):  
Risk Factors ◽  
Clinical Outcomes ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Placenta Accreta Spectrum

scholarly journals Placenta Accreta Spectrum Disorder in a Patient with Six Previous Caesarean Deliveries: Step by Step Management

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Calagna Gloria ◽  
Polito Salvatore ◽  
Labate Francesco ◽  
Guiglia Rosa Anna ◽  
De Maria Francesca ◽  
...  
Keyword(s):  
Risk Factors ◽  
Scientific Community ◽  
Caesarean Delivery ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
International Federation ◽  
Difficult Case ◽  
Referral Center ◽  
Placenta Accreta Spectrum ◽  
Spectrum Disorders

The definition placenta accreta spectrum disorders (PAS) introduced by FIGO (International Federation of Gynaecology and Obstetrics) indicates an abnormal, pathological adherence or invasion of the placenta. The growing worldwide incidence of this pathological entity, and the possible serious correlated surgical risks, has caused a significant increase in attention among the scientific community. Previous caesarean delivery and presence of placenta previa are the main risk factors for the onset of PAS. Here, we present the intriguing case of a 39-year-old woman, at the 33rd week of gestation, with six previous caesarean sections and with a diagnosis of placenta previa accreta. At our referral center for PAS disorders, we successfully managed this difficult case with the help of a multidisciplinary skilled team.

scholarly journals Effects of Placenta Location in Pregnancy Outcomes of Placenta Accreta Spectrum (PAS); A Retrospective Cohort Study

2021 ◽  
Author(s):  
Shokoh Abotorabi ◽  
Solmaz Chamanara ◽  
Sonia Oveisi ◽  
Maryam Rafiei ◽  
Leila Amini
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Chi Square ◽  
Gestational Age At Delivery ◽  
History Of ◽  
Placenta Accreta Spectrum

Objective: Placenta Accreta Spectrum (PAS) affects approximately one in a thousand deliveries. Very few studies evaluated PAS risk factors based on their location. In this study, we have investigated the effects of placenta location on placental adhesion-related complications, its risk factors, and outcomes. Materials and methods: We performed a retrospective cohort study of pathology-confirmed cases of PAS from patients with peripartum hysterectomy, at a large educational hospital in Qazvin, Iran, from 2009 to 2019. Placenta location was found by ultrasound reports and intraoperative evaluation. We measured demographic features, basic characteristics, maternal and neonatal outcomes based on placental location including anterior, posterior, and lateral in Placenta Accreta Spectrum. Chi-square, t-test, and one-way ANOVA were used to examine the relation of complications, risk factors, and outcomes in PAS. Results: A review of 70 cases showed the distribution of placenta location as follows: 57% anterior, 27% posterior, and 16% lateral. The mean gestational age at delivery was 35 (33-39) weeks. In 78.6% (n=55) of the patients, an association with placenta previa and in 94/2% (n=66) of cases a history of cesarean section was found, however, it was not significantly correlated with placenta location (p=0.082). We found that surgery duration was significantly longer in patients with lateral PAS (155±38, vs 129.35±33.8 and 133.15±31.5 for anterior and posterior placenta respectively, p=0.09). Patients with lateral PAS also bled more than the remaining two groups (2836 ml for lateral PAS vs 2002 and 1847 for anterior and posterior placenta respectively, p=0.022). Moreover, women with a history of uterine surgery were more likely to have posterior PAS compared to those with anterior and lateral PAS (p=0.035). Conclusion: Differences in complications, risk factors, and outcomes of PAS based on placenta location may lead to improved diagnosis and decreased morbidity in women.

PLACENTA PREVIA AND PLACENTA ACCRETA SPECTRUM (PAS) DISORDER: INCIDENCE, RISK FACTOR AND FETOMATERNAL OUTCOME IN A TERTIARY CARE CENTER

2021 ◽  
pp. 15-17
Author(s):  
Ramona Perhar ◽  
Rubi Devi ◽  
Ruchi Patel ◽  
Jagriti Jagriti
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Care Center ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Adherent Placenta ◽  
Placenta Accreta Spectrum

Introduction: Placenta Previa is characterised by Placental implantation into the lower uterine segment covering whole or part of the cervix . It complicates 0.4% of pregnancy at term The average incidence is 0.3% or 1 case per 300 to 400 deliveries. The presence of placenta previa can also increase a woman's risk for placenta accreta spectrum (PAS). This spectrum of conditions includes placenta accreta, increta, and percreta. Uncontrolled postpartum hemorrhage from placenta previa or PAS may necessitate a blood transfusion, hysterectomy thus leaving the patient infertile, admission to the ICU, or even death. Material and method: Study was conducted in department of obstetrics & gynecology , swaroop rani hospital, Allahabad for 1 year . A total of 102 pregnant women presenting to antenatal OPD or admitted in IPD with history of antepartum hemorrhage and conrmed case of PP or MAP in Ultrasonography were selected. The follow up till the fetomaternal outcome was done and risk factors were evaluated for 102 cases. Result: Out of the total 2342 deliveries in one year 95 patients had PP and the incidence was 4.04% and 7 patients had morbidily adherent Placenta which accounts to an incidence of 0.29%. Previous LSCS, Multiparity, increase maternal age, Dialatation and curettage were risk factors in both Placenta Previa and Morbidily Adherent Placenta. Antenatal complication were antepartum hemmorrhage , Anemia, preterm labor. Emergency LSCS is more common mode of delivery in cases of Placenta previa. Caesarean hysterectomy were done in 3.2% cases of Placenta Previa and all cases of Morbidily adherent placenta . Most common perinatal complications in both groups were prematurity and low birth weight. Conclusion: Now a days Placenta previa and Morbidily adherent placenta are very common. Incidence increases as the rate of cesaerean section or abdominal surgery were increases.Earlydiagnosis and pre plan mode of delivery will decrease the risk of prematurity and low birth weight.

scholarly journals Maternal and fetal outcome in placenta accreta spectrum (PAS) associated with placenta previa: a retrospective analysis from a tertiary center

2021 ◽  
Vol 14 (3) ◽  
pp. 367-375
Author(s):  
◽  
◽  
◽  
Valentin Nicolae Varlas ◽  
Roxana Georgiana Bors ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cesarean Delivery ◽  
Conservative Management ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Maternal Blood ◽  
Uterine Preservation ◽  
Tertiary Center ◽  
Placenta Accreta Spectrum ◽  
The Mean

Accreta placenta spectrum is a complex obstetrical condition of abnormal placental invasion associated with severe maternal morbidity. This study aimed to analyze our therapeutic management and counseling of the cases with placenta accreta spectrum (PAS) associated with placenta previa. We performed a retrospective study of pregnant women with PAS associated with placenta previa at the Filantropia Clinical Hospital between January 2017–April 2021. In these cases, the earlier diagnosis was realized by an ultrasonographic scan and was confirmed by histopathological findings after the surgical treatment. The conservative management was obtained in one case at <37 weeks of gestation, and the maternal outcome was uterine preservation. Among the 12 patients, the mean age was 34±3.44 years. All women had risk factors for abnormally invasive placenta, such as placenta previa or previous cesarean delivery. Most women underwent planned cesarean delivery at the mean gestational age of 36.4±0.9 weeks. In our study, the uterus was preserved in only one case (8.33%), and hysterectomy with preservation of ovaries was performed in the rest of the cases. Mean maternal blood loss during surgery was 2175±1440 ml. Severe maternal outcomes were recorded only in one case (8.33%). We identified a low uterine preservation rate and a good perinatal outcome. Conservative management should be reserved for fertility desire and extensive disease due to surgical difficulty. Early identification of the risk factors and strategic management may improve maternal and fetal outcomes.

scholarly journals Risk factors for placenta accreta spectrum: findings from the Japan environment and Children’s study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Hyo Kyozuka ◽  
◽  
Akiko Yamaguchi ◽  
Daisuke Suzuki ◽  
Keiya Fujimori ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Reproductive Technology ◽  
Birth Cohort Study ◽  
Cesarean Sections ◽  
Smoking During Pregnancy ◽  
Uterine Anomalies ◽  
Placenta Accreta Spectrum

Abstract Background Placenta accreta spectrum (PAS) is a life-threating complication in the field of obstetrics. Sometimes we face with unexpected PAS cases which is potentially higher maternal mortality and morbidity compared with expected cases. The present study was conducted to examine the prevalence of PAS and to elucidate its risk factors using a large Japanese birth cohort study. Methods We reviewed the results of a nationwide prospective birth cohort study in Japan, and identified 90,554 participants treated from 2011 to 2014 in 15 regional centers. Multiple regression models were created to identify the risk factors for PAS. These data were obtained from self-reported questionnaires or patient medical records. Results This analysis consisted of 202 cases of PAS (18 with placenta previa and 184 without placenta previa) and 90,352 cases without PAS. The multiple logistic regression analysis showed that placenta previa (adjusted odds ratio [aOR]: 12.86, 95% confidence interval [CI] 7.70–21.45, P < 0.001), assisted reproductive technology-related pregnancies (aOR: 6.78, 95% CI 4.54–10.14, P < 0.001), smoking during pregnancy (aOR: 1.95, 95% CI 1.15–3.31, P = 0.013), more than two previous cesarean sections (aOR: 2.51, 95% CI 1.35–4.67, P = 0.004), and uterine anomalies (aOR: 3.97, 95% CI 1.24–12.68, P = 0.020) increased the risk of PAS. Conclusion In general population, placenta previa, assisted reproductive technology-related pregnancy, smoking during pregnancy, repeated cesarean sections, and uterine anomalies were risk factors for PAS in the Japanese population.

scholarly journals Anaesthetic Practices and Maternal Outcome in Rising Placenta Accreta Spectrum in Tertiary Care Hospital

2020 ◽  
Vol 24 (2) ◽  
pp. 108-111
Author(s):  
Sumbal Rana ◽  
Ali Arslan Munir ◽  
Qudsia Anjum Quraishi ◽  
Amim Muhammad Akhtar ◽  
Erum Pervaiz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multidisciplinary Team ◽  
Maternal Age ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Tertiary Care ◽  
Care Hospital ◽  
Placenta Accreta Spectrum ◽  
Team Interventions ◽  
Previous Cesarean

Objective: This study was carried out to determine whether the rate of abnormal placentation is increasing in concurrence with the cesarean section and to assess risk factors and outcomes with multidisciplinary team interventions and anesthetic practices. Study design: Prospective cohort study. Material & Methods: A study was conducted in the department of anaesthesia from January 2014 to December 2017. All candidates under the spectrum of placenta accreta were observed for maternal age, parity, mode of anesthesia, blood loss, and outcome. Results: Out of 109 patients, the preoperative diagnosis of PAS was made up of 100 (91.74%) and intraoperative diagnosis of 9 (08. 26%) patients. According to the mode of anesthesia, 100 (91.74%) patients received GA, and 09 (08.26%) patients received spinal anesthesia. In 06 (05.49%) patients, spinal was converted to GA. Perioperative CPR was done in 05 (04.58%) cases. Out of 109 cases, 83 survived uneventfully, and 21 developed complications. 05 patients expired in the following days. (01 immediately postoperative period, 02 in 1st 24 hours and 02 in 1st 48 hours. Conclusion The rate of placenta accreta increased in conjunction with cesarean deliveries; the most important risk factors were previous cesarean delivery, placenta previa, and advanced maternal age and outcomes improved in a multidisciplinary team intervention.

Placental thickness correlates with placenta accreta spectrum (PAS) disorder in women with placenta previa

2021 ◽  
Author(s):  
Yan Li ◽  
Hailey H. Choi ◽  
Ruth Goldstein ◽  
Liina Poder ◽  
Priyanka Jha
Keyword(s):  
Placenta Accreta ◽  
Placenta Previa ◽  
Placenta Accreta Spectrum ◽  
Placental Thickness

Qualitative evaluation of MR images for assessing placenta accreta spectrum disorders in patients with placenta previa: a pilot validation study

2021 ◽  
pp. 110078
Author(s):  
Simone Maurea ◽  
Francesco Verde ◽  
Pier Paolo Mainenti ◽  
Luigi Barbuto ◽  
Francesca Iacobellis ◽  
...  
Keyword(s):  
Validation Study ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Qualitative Evaluation ◽  
Mr Images ◽  
Placenta Accreta Spectrum ◽  
Spectrum Disorders
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