High prevalence of intrapelvic parasitic arteries in patients with placenta accreta spectrum: A case-control study using unenhanced magnetic resonance angiography

Abstract Background Placenta accreta spectrum is a serious obstetric disorder that is characterized by deeply penetrating villi which are abnormally attached to the myometrium of the uterus. This prevents its complete dissociation during the third stage of labor that may cause severe bleeding, with its marked risk on the mother life. All recent studies confirm that the occurrence of placenta accreta increased dramatically in the recent years with the increasing number of caesarean sections. The number of previous caesarean deliveries accompanied by placenta previa markedly increase the risk for placenta accreta. There is a continued need to study risk factors of abnormally adherent placenta to improve the antenatal diagnosis . Objective The current study aims to evaluate the effect of the short duration between the perior caesarean delivery and the current pregnancy on the occurence of placenta accreta spectrum. Patients and Methods a case control study which was performed in the Maternity Hospital of Ain Shams University. It compare the duration between the perior caesarean section and the current pregnancy in the placenta accreta cases and the matched controls to determine if it increases the occurrences of placenta accreta or not. It include all pregnant ladies with placenta accreta spectrum diagnosed radiologically or surgically in the period of the beginning of June 2019 to the beginning of December 2019 with in the inclusion criteria, also the matched controls. Results there was no difference with a statistical significance between control group and patients group regarding inter pregnancy interval. Conclusion this study reveals that there was no effect of the short duration between the previous caesarean delivery and the current pregnancy on the occurence of placenta accreta spectrum.

Download Full-text

The application of prophylactic balloon occlusion of the internal iliac artery for the treatment of placenta accreta spectrum with placenta previa: a retrospective case-control study

BMC Pregnancy and Childbirth ◽

10.1186/s12884-020-03041-4 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Ying Peng ◽

Lai Jiang ◽

Cheng Peng ◽

Dabao Wu ◽

Ling Chen

Keyword(s):

Case Control Study ◽

Internal Iliac Artery ◽

Placenta Accreta ◽

Placenta Previa ◽

Case Control ◽

Balloon Occlusion ◽

Retrospective Case ◽

Internal Iliac ◽

Placenta Accreta Spectrum ◽

Control Study

Download Full-text

Prevalence of Extracranial venous Narrowing on Magnetic Resonance Venography is Similar in People with Multiple Sclerosis, Their Siblings, and Unrelated Healthy Controls: A Blinded, Case-Control Study

Canadian Association of Radiologists Journal ◽

10.1016/j.carj.2016.07.002 ◽

2017 ◽

Vol 68 (2) ◽

pp. 202-209 ◽

Cited By ~ 3

Author(s):

Nancy Martin ◽

Anthony L. Traboulsee ◽

Lindsay Machan ◽

Darren Klass ◽

Tasha Ellchuk ◽

...

Keyword(s):

Multiple Sclerosis ◽

Magnetic Resonance ◽

Gold Standard ◽

Venous Insufficiency ◽

Case Control Study ◽

Study Groups ◽

Case Control ◽

Significant Difference ◽

High Prevalence ◽

Control Study

Purpose The study sought to assess and compare the prevalence of narrowing of the major extracranial veins in subjects with multiple sclerosis and controls, and to assess the sensitivity and specificity of magnetic resonance venography (MRV) for describing extracranial venous narrowing as it applies to the chronic cerebrospinal venous insufficiency theory, using catheter venography (CV) as the gold standard. Methods The jugular and azygos veins were assessed with time-of-flight MRV in this assessor-blinded, case-control study of subjects with multiple sclerosis, their unaffected siblings, and unrelated controls. The veins were evaluated by diameter and area, and compared with CV. Collateral vessels were also analyzed for maximal diameter, as a potential indicator of compensatory flow. Results A high prevalence of extracranial venous narrowing was demonstrated in all study groups, collectively up to 84% by diameter criteria and 90% by area, with no significant difference between the groups when assessed independently ( P = .34 and .63, respectively). There was high interobserver variability in the reporting of vessel narrowing (kappa = 0.32), and poor vessel per vessel correlation between narrowing on MRV and CV (kappa = 0.064). Collateral neck veins demonstrated no convincing difference in maximum size or correlation with jugular narrowing. Conclusion There is a high prevalence of narrowing of the major extracranial veins on MRV in all 3 study groups, with no significant difference between them. These findings do not support the chronic cerebrospinal venous insufficiency theory. Although MRV has shown a high sensitivity for identifying venous narrowing, time-of-flight imaging demonstrates poor interobserver agreement and poor specificity when compared with the gold standard CV.

Download Full-text

Incidence, risk factors and perinatal outcomes for placenta accreta in Australia and New Zealand: a case–control study

BMJ Open ◽

10.1136/bmjopen-2017-017713 ◽

2017 ◽

Vol 7 (10) ◽

pp. e017713 ◽

Cited By ~ 21

Author(s):

Cynthia M Farquhar ◽

Zhuoyang Li ◽

Sarah Lensen ◽

Claire McLintock ◽

Wendy Pollock ◽

...

Keyword(s):

Risk Factors ◽

New Zealand ◽

Caesarean Section ◽

Case Control Study ◽

Placenta Accreta ◽

Perinatal Outcomes ◽

Case Control ◽

Secondary Outcome ◽

Incidence Risk ◽

Control Study

ObjectiveEstimate the incidence of placenta accreta and describe risk factors, clinical practice and perinatal outcomes.DesignCase–control study.SettingSites in Australia and New Zealand with at least 50 births per year.ParticipantsCases were women giving birth (≥20 weeks or fetus ≥400 g) who were diagnosed with placenta accreta by antenatal imaging, at operation or by pathology specimens between 2010 and 2012. Controls were two births immediately prior to a case. A total of 295 cases were included and 570 controls.MethodsData were collected using the Australasian Maternity Outcomes Surveillance System.Primary and secondary outcome measuresIncidence, risk factors (eg, prior caesarean section (CS), maternal age) and clinical outcomes of placenta accreta (eg CS, hysterectomy and death).ResultsThe incidence of placenta accreta was 44.2/100 000 women giving birth (95% CI 39.4 to 49.5); however, this may overestimated due to the case definition used. In primiparous women, an increased odds of placenta accreta was observed in older women (adjusted OR (AOR) women≥40 vs <30: 19.1, 95% CI 4.6 to 80.3) and current multiple birth (AOR: 6.1, 95% CI 1.1 to 34.1). In multiparous women, independent risk factors were prior CS (AOR ≥2 prior sections vs 0: 13.8, 95% CI 7.4 to 26.1) and current placenta praevia (AOR: 36.3, 95% CI 14.0 to 93.7). There were two maternal deaths (case fatality rate 0.7%).Women with placenta accreta were more likely to have a caesarean section (AOR: 4.6, 95% CI 2.7 to 7.6) to be admitted to the intensive care unit (ICU)/high dependency unit (AOR: 46.1, 95% CI 22.3 to 95.4) and to have a hysterectomy (AOR: 209.0, 95% CI 19.9 to 875.0). Babies born to women with placenta accreta were more likely to be preterm, be admitted to neonatal ICU and require resuscitation.

Download Full-text