scholarly journals Possible limitation to use the International Federation of Gynecology and Obstetrics classification of placenta accreta spectrum

2020 ◽  
Vol 223 (6) ◽  
pp. 944
Author(s):  
José M. Palacios-Jaraquemada ◽  
Francesco D’Antonio
Keyword(s):  
Placenta Accreta ◽  
International Federation ◽  
Gynecology And Obstetrics ◽  
Placenta Accreta Spectrum

scholarly journals Soluble FMS-Like Tyrosine Kinase-1: Role in placenta accreta spectrum disorder

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 618
Author(s):  
Sarma Lumbanraja ◽  
M Rizki Yaznil ◽  
Andre M Siahaan ◽  
Bancin Berry Eka Parda
Keyword(s):  
Tyrosine Kinase ◽  
Placenta Accreta ◽  
Uterine Wall ◽  
Spectrum Disorder ◽  
Control Group ◽  
P Value ◽  
Case Group ◽  
Gynecology And Obstetrics ◽  
Placenta Accreta Spectrum ◽  
Multi Center Study

Background: Placenta accreta is a pregnancy condition where the placenta's blood vessels attach too deeply to the uterine wall. Incidence of placenta accreta  is increasingly seen today as the rate of cesarean section increases, however, the exact pathophysiology of this condition is still not fully understood. Soluble fms-like tyrosine kinase-1  (sflt-1) as a protein produced by the placenta was found to be decreased in placenta accreta, Therefore we aim  to see if  sfltsFlt-1 has a role in the development of placenta accreta. Methods: This study involved 40 samples from patients that had been diagnosed with placenta accreta spectrum disorder (case group), and 40 samples from patients with normal pregnancies (control group)  at Rumah Skit Umum Pusat H.Adam Malik (RSUP) Haji Adam Malik Medan, in Indonesia.  Diagnosis of placenta accreta syndrome was based on Placenta Accreta Spectrum  Score (PAS), and International Federation of Gynecology and Obstetrics  (FIGO) classification of placenta accreta spectrum disorder.Analyses  were performed by independent t-test, man Mann-Whitney U test, and Kruskal-Wallis analysis test, with a P-value <0.05  considered as statistically significant (95%CI). Results: Based on this study, we found that the sFlt-1 level in the case group was lower than the control group. Data analysis using the Kruskal-Wallis test showed that there was a difference in sFlt-1 levels in this study group (p = 0.02), which was further evaluated  with post hoc analysis using Mann. -Whitney U test. The results indicated that there were significant differences between the control and PAS 0, PAS1, and PAS 2 (p = 0.043; p = 0.002; p = 0.03). Conclusion: sFlt-1 levels decreased in placental invasive pregnancies compared to normal pregnancies, however, this still needs to be investigated further in a multi-center study, considering that sFlt-1 levels are also influenced by ethnicity and other conditions that cannot be excluded in this study.

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 Soluble FMS-Like Tyrosine Kinase-1: Role in placenta accreta spectrum disorder

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 618
Author(s):  
Sarma Lumbanraja ◽  
M Rizki Yaznil ◽  
Andre M Siahaan ◽  
Bancin Berry Eka Parda
Keyword(s):  
Tyrosine Kinase ◽  
Placenta Accreta ◽  
Uterine Wall ◽  
Spectrum Disorder ◽  
Control Group ◽  
P Value ◽  
Case Group ◽  
Gynecology And Obstetrics ◽  
Placenta Accreta Spectrum ◽  
Multi Center Study

Background: Placenta accreta is a pregnancy condition where the placenta's blood vessels attach too deeply to the uterine wall. Incidence of placenta accreta  is increasingly seen today as the rate of cesarean section increases, however, the exact pathophysiology of this condition is still not fully understood. Soluble fms-like tyrosine kinase-1  (sflt-1) as a protein produced by the placenta was found to be decreased in placenta accreta, Therefore we aim  to see if  sfltsFlt-1 has a role in the development of placenta accreta. Methods: This study involved 40 samples from patients that had been diagnosed with placenta accreta spectrum disorder (case group), and 40 samples from patients with normal pregnancies (control group)  at Rumah Skit Umum Pusat H.Adam Malik (RSUP) Haji Adam Malik Medan, in Indonesia.  Diagnosis of placenta accreta syndrome was based on Placenta Accreta Spectrum  Score (PAS), and International Federation of Gynecology and Obstetrics  (FIGO) classification of placenta accreta spectrum disorder.Analyses  were performed by independent t-test, man Mann-Whitney U test, and Kruskal-Wallis analysis test, with a P-value <0.05  considered as statistically significant (95%CI). Results: Based on this study, we found that the sFlt-1 level in the case group was lower than the control group. Data analysis using the Kruskal-Wallis test showed that there was a difference in sFlt-1 levels in this study group (p = 0.02), which was further evaluated  with post hoc analysis using Mann. -Whitney U test. The results indicated that there were significant differences between the control and PAS 0, PAS1, and PAS 2 (p = 0.043; p = 0.002; p = 0.03). Conclusion: sFlt-1 levels decreased in placental invasive pregnancies compared to normal pregnancies, however, this still needs to be investigated further in a multi-center study, considering that sFlt-1 levels are also influenced by ethnicity and other conditions that cannot be excluded in this study.

scholarly journals Clinical limitations of the International Federation of Gynecology and Obstetrics (FIGO) classification of uterine fibroids

2017 ◽  
Vol 139 (2) ◽  
pp. 143-148 ◽  
Author(s):  
Shannon K. Laughlin-Tommaso ◽  
Gina K. Hesley ◽  
Matthew R. Hopkins ◽  
Kathleen R. Brandt ◽  
Yunxiao Zhu ◽  
...  
Keyword(s):  
Uterine Fibroids ◽  
International Federation ◽  
Gynecology And Obstetrics ◽  
Figo Classification

scholarly journals Texture analysis of dark intraplacental bands on T2WI in the evaluation of placenta accreta spectrum disorders: a feasibility study

2021 ◽  
Author(s):  
Lishan Dong ◽  
Hailin Shen ◽  
Sheng Wang ◽  
Zhiyi Lei ◽  
Jiangong Zhang ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Model ◽  
Texture Analysis ◽  
Logistic Regression Model ◽  
Placenta Accreta ◽  
Objective Assessment ◽  
Registration Number ◽  
Placenta Accreta Spectrum ◽  
Spectrum Disorders

Abstract Background: To evaluate whether texture analysis of dark intraplacental bands on T2WI can provide a novel methodological viewpoint valuable in assessing the classification of placenta accreta spectrum disorders (PAS disorders).Methods: 174 participants with suspected PAS disorders were consecutively included in the study. Texture analysis was implemented on dark intraplacental bands on T2WI by MaZda software. The two steps of parameter selection and reduction led to a decrease of the parameter space dimensionality. The logistics regression models were constructed with texture parameters to evaluate the classification of PAS disorders.Results: Both run length nonuniformity (RLN) and grey level nonuniformity (Gle) of four directions showed significant differences between participants with placenta accreta, increta and percreta (P﹤0.05). The AUC and cut-off for logistic regression model of accreta vs increta were 0.75 (95% CI: 0.54, 0.90) and 6.72, respectively; corresponding values for logistic regression model of increta vs percreta were 0.81 (95% CI: 0.61, 0.93) and 10.92. The sensitivity and specificity for cut-off of 6.72 were 88.46% and 84.62%, respectively; corresponding values for cut-off of 10.92 were 92.59% and 85.71%.Conclusion: Texture analysis offered promise for more quantitative and objective assessment of PAS disorders than other image modalities. It may be a useful add-on to MRI in evaluating the classification of PAS disorders. Trial registration: Registration number: ChiCTR2000038604 and name of registry: Evaluation of diagnostic accuracy of MRI multi-parameter imaging combined with texture analysis for placenta accreta spectrum disorders (PAD).

scholarly journals Soluble FMS-Like Tyrosine Kinase: Role in placenta accreta spectrum disorder

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 618
Author(s):  
Sarma Lumbanraja ◽  
M Rizki Yaznil ◽  
Andre M Siahaan ◽  
Bancin Berry Eka Parda
Keyword(s):  
Tyrosine Kinase ◽  
Placenta Accreta ◽  
Uterine Wall ◽  
Spectrum Disorder ◽  
Control Group ◽  
P Value ◽  
Case Group ◽  
Gynecology And Obstetrics ◽  
Placenta Accreta Spectrum ◽  
Multi Center Study

Background: Placenta accreta is a pregnancy condition where the placenta's blood vessels attach too deeply to the uterine wall. Incidence of placenta accreta  is increasingly seen today as the rate of cesarean section increases, however, the exact pathophysiology of this condition is still not fully understood. Soluble fms-like tyrosine kinase-1  (sflt-1) as a protein produced by the placenta was found to be decreased in placenta accreta, Therefore we aim  to see if  sflt-1 has a role in the development of placenta accreta. Methods: This study involved 40 samples from patients that had been diagnosed with placenta accreta spectrum disorder (case group), and 40 samples from patients with normal pregnancies (control group)  at Rumah Skit Umum Pusat H.Adam Malik (RSUP) Haji Adam Malik Medan, in Indonesia.  Diagnosis of placenta accreta syndrome was based on Placenta Accreta Spectrum  Score (PAS), and International Federation of Gynecology and Obstetrics  (FIGO) classification of placenta accreta spectrum disorder.Analyses  were performed by independent t-test, man Whitney U test, and Kruskal-Wallis analysis test, with a P-value <0.05  considered as statistically significant (95%CI). Results: Based on this study, we found that the sFlt-1 level in the case group was lower than the control group. Data analysis using the Kruskal-Wallis test showed that there was a difference in sFlt-1 levels in this study group (p = 0.02), which was further evaluated  with post hoc analysis using Mann. Whitney U test. The results indicated that there were significant differences between the control and PAS 0, PAS1, and PAS 2 (p = 0.043; p = 0.002; p = 0.03). Conclusion: sFlt-1 levels decreased in placental invasive pregnancies compared to normal pregnancies, however, this still needs to be investigated further in a multi-center study, considering that sFlt-1 levels are also influenced by ethnicity and other conditions that cannot be excluded in this study.

Placenta Accreta Spectrum: Correlation between FIGO Clinical Classification and Histopathologic Findings

2021 ◽  
Author(s):  
Soroush Aalipour ◽  
Bahram Salmanian ◽  
Karin A. Fox ◽  
Steven Leigh Clark ◽  
Amir A. Shamshirsaz ◽  
...  
Keyword(s):  
Placenta Accreta ◽  
Wide Spectrum ◽  
Definitive Treatment ◽  
Future Research ◽  
Fisher Exact Test ◽  
Clinical Classification ◽  
Maternal Complications ◽  
Gynecology And Obstetrics ◽  
Placenta Accreta Spectrum ◽  
Histopathologic Findings

Objective Placenta accreta spectrum (PAS) covers a wide spectrum of placental adherence/invasion with varied clinical significance. Histopathologic examination is considered the confirmatory gold standard, but is only obtained sometime after definitive treatment. The International Federation of Gynecology and Obstetrics (FIGO) has published a new clinical classification that can be assigned at delivery, and we aimed to investigate the association between this new FIGO classification and histopathology and also to assess its correlation with maternal outcomes. Study Design We studied a retrospective cohort of 185 subjects with histopathologically proven PAS managed at our referral center between September 2012 and January 2019. Two experienced surgeons retrospectively reviewed charts and assigned the FIGO grading based on findings reported at delivery. A third experienced reviewer adjudicated to determine the classification used for final analysis. Categorical outcomes were compared with the use of chi-squared and the Fisher exact test, as appropriate. A multivariate model was designed to adjust outcomes in different FIGO groups for the involvement of a formal multidisciplinary management team. Results Among 185 subjects, there were 41 (22%) placenta accreta, 44 (24%) placenta increta, and 100 (54%) placenta percreta on histopathology. The inter-rater reliability was found to be substantial with Kappa = 0.661 (p < 0.001), and 95% confidence interval (CI): 0.449–0.872. There was a significant association between all histopathology groupings and the FIGO clinical classification (p < 0.001). However, we found no association between FIGO classifications and maternal complications. Conclusion The new FIGO clinical classification is strongly associated with histopathologic findings. A better understanding of the depth and extent of invasion as afforded by the clinical classification system will help standardize reporting and future research. Key Points

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