Role of placenta accreta index in prediction of morbidly adherent placenta: A reliability study

Ultrasound ◽  
2020 ◽  
pp. 1742271X2095974
Author(s):  
Shubhra Agarwal ◽  
Arjit Agarwal ◽  
Shruti Chandak
Keyword(s):  
Scoring System ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Intraclass Correlation ◽  
Interrater Agreement ◽  
Baseline Risk ◽  
Individual Risk ◽  
Predictive Values ◽  
Morbidly Adherent Placenta ◽  
Adherent Placenta

Objective To estimate the level of interobserver agreement in the calculation of placenta accreta index (PAI) as well as to evaluate the accuracy of PAI in prediction of morbidly adherent placenta. Materials and methods This was a prospective study where 45 pregnant women (from 28 to 37 weeks of gestational age) with at least one previous Caesarean section and ultrasound-proven placenta previa were included. A known and previously published scoring system, the PAI, was evaluated independently by two radiologists and the cases were followed for the delivery and histopathology outcome. The accuracy of the PAI and the level of interrater agreement was analysed using cross-table analysis, intraclass correlation efficient and Cohen’s kappa as statistical variables. Results Adherent placenta was found in 15 patients accounting for 33% of cases. The PAI showed nearly 90% sensitivity, specificity and the predictive values. Interrater agreement in calculation of PAI by the two radiologists was perfect with an intraclass correlation efficient of 0.959. An easy-to-use morbid adherent placenta score was also predicted to simplify the results of PAI, which showed moderate agreement (κ = 0.746). Conclusions The PAI can be helpful in stratifying the individual risk of placental invasion above the baseline risk. The PAI-derived, simplified scoring system called morbid adherent placenta score can be used as a simple tool to interpret and convey the results of PAI.

scholarly journals Placenta praevia: percreta and accreta, our experience

2020 ◽  
Vol 9 (3) ◽  
pp. 928
Author(s):  
Preeti F. Lewis ◽  
Shreya Chinchoriya
Keyword(s):  
Risk Factors ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Tertiary Care ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Morbidly Adherent Placenta ◽  
Adherent Placenta ◽  
History Of ◽  
Previous Cesarean

Background: morbidly adherent placenta has an increasing incidence over decades. The purpose of this study is to identify risk factors and etiology of placenta previa- accreta and percreta.Methods: A cross sectional observational study of patients with morbidly adherent placenta previa including placenta accreta and placenta percreta were studied over a period of three years from June 2017 to June 2019 in a tertiary care centre, Mumbai.Results: Cases showed a higher incidence in patients with previous cesarean delivery (CS), grandmultiparity, abortions without the history of check curettage and anterior/central placentae.Conclusions: History of uterine surgeries and previous cesarean are some important risk factors for accreta in placenta previa patients.

scholarly journals Predictive values of ultrasound-based scoring system in morbidly adherent placenta for high risk group

2018 ◽  
Vol 7 (11) ◽  
pp. 4426
Author(s):  
Abd El-Naser Abd El-Gaber Ali ◽  
Ahmed AM. Mohammad ◽  
Mustafa M. Khodry ◽  
Khaled M. Abdallah ◽  
Ahmed M. Abbas
Keyword(s):  
High Risk ◽  
Pregnant Women ◽  
Scoring System ◽  
Risk Group ◽  
High Risk Group ◽  
Elective Cesarean Section ◽  
Predictive Values ◽  
Morbidly Adherent Placenta ◽  
Adherent Placenta ◽  
Sensitivity Specificity

Background: The objective of the present study was to find out the predictive values of an ultrasound-based scoring system in diagnosis of morbidly adherent placenta (MAP) for high risk group. Obstetrics and Gynecology Department, Faculty of Medicine, South Valley University, Egypt.Methods: 63 full term pregnant women (≥37 weeks of gestation) with high risk of morbidly adherent placenta underwent elective cesarean section. Placental assessment by 2 D ultrasound based on ultrasound scoring system in morbidly adherent placenta, these data were recorded for further comparison with intraoperative data for degree of placental adherence.Results: Incidence of MAP was 7.93% (4.76% had a focal form and 3.17% had a complete form of accreta). As regarding to scoring system, 82.5 of cases had a low risk (< 5), 9.5% had a moderate risk (6-7) and 7.93% had a high risk (8-12) of development of morbidly adherent placenta with p value <0.0001. The sensitivity, specificity, positive and negative predictive values of the US scoring system for morbidly adherent placenta were (92.3%, 94.1%, 87.453% and 98.2%) respectively.Conclusions: Ultrasound based scoring system had a high predictive value (sensitivity, specificity, positive and negative predictive values) in diagnosis of morbidly adherent placenta for pregnant women have any risk factors for developing MAP.

Alpha Feto-Protien as a Biochemical Marker in Prediction of Morbidly Adherent Placenta

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Hassan Tawfik Khairy ◽  
Mohammed Saeed Eldin El Safty ◽  
Rasha Medhat Abd El Hadi ◽  
Kyrollos Refat Khalf Marzok
Keyword(s):  
Cesarean Delivery ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Power Doppler ◽  
Morbidly Adherent Placenta ◽  
Adherent Placenta ◽  
3D Power Doppler ◽  
Tertiary Center ◽  
Previous Cesarean

Abstract Background Placenta accreta is a potentially life-threatening obstetric condition that requires a multidisciplinary approach to management. The incidence of placenta accreta has increased and seems to parallel the increasing cesarean delivery rate. Women at greatest risk of placenta accreta are those who have myometrial damage caused by a previous cesarean delivery with either an anterior or posterior placenta previa overlying the uterine scar. Diagnosis of placenta accreta before delivery allows multidisciplinary planning in an attempt to minimize potential maternal or neonatal morbidity and mortality. Aim of the Work To compare between alpha-fetoproteine as biological marker & ultrasound & Doppler findings for prenatal predication of morbid adherent placentation in anterior placenta on scar of previous cesarean section. Patients and Methods The current study is a prospective cohort study, conducted at a tertiary center: Ain Shams University Maternity Hospital during the period between February 2018 and April 2019,where 150 pregnant women having placenta previa covering scar of previous uterine surgery had been recruited from the outpatient obstetrics clinic or emergency room and admitted to antepartum inpatient high risk service, but 50 patients were dropped out due to loss in follow up because of emergency antepartum haemorrhage & C.S., others escaped follow up. Results The results of the current study showed a significant association between all criteria of the 3DPD with multislice view and presence of placental adherence, need for added surgical steps, CS hysterectomy and bladder injury with sensitivity 83% & specificity 57%, PPV 76%, NPV 66%. Conclusion The current study suggests that AFP assay, it isn't good test alone as regards its sensitivity &specificity &its level of accuracy 55% as compared to 2D &3D power doppler with multislice view, so it is unreliable test alone for antenatal diagnosis of morbidly adherent placenta.

scholarly journals 367: Validation of the placenta accreta index to predict morbidly adherent placenta

2017 ◽  
Vol 216 (1) ◽  
pp. S222
Author(s):  
Sarah K. Happe ◽  
C. Edward Wells ◽  
Jodi S. Dashe ◽  
Martha W.F. Rac ◽  
Donald D. McIntire ◽  
...  
Keyword(s):  
Placenta Accreta ◽  
Morbidly Adherent Placenta ◽  
Adherent Placenta

scholarly journals Delayed bleeding after prophylactic bilateral internal iliac artery balloon occlusion in elective caesarean hysterectomy for the management of placenta accreta

2017 ◽  
Vol 6 (4) ◽  
pp. 1656
Author(s):  
Abdul Karim Othman ◽  
Noraslawati Razak ◽  
Mohd Hanif Che Mat
Keyword(s):  
Iliac Artery ◽  
Internal Iliac Artery ◽  
Placenta Previa ◽  
Balloon Occlusion ◽  
Morbidly Adherent Placenta ◽  
Adherent Placenta ◽  
Internal Iliac ◽  
Life Threatening ◽  
Caesarean Hysterectomy ◽  
Placenta Accrete

Morbidly adherent placenta (MAP) can be divided into placenta accrete, placenta increta and placenta percreta. It is associated with high parity, multifetal gestation, advanced maternal age, assisted reproductive technologies, placenta previa, and more importantly a history of caesarean section or uterine surgery. Globally, the incidence of placenta accrete has increased and seems to be in parallel with the increasing rate of caesarean section delivery.Despite rapidly evolving diagnostic imaging, and growing of surgical expertise, morbidly adherent placenta (MAP) remains an important cause of maternal morbidity and mortality, especially related with life-threatening postpartum haemorrhage. Although the choice of treatment for placenta accrete is puerperal hysterectomy, this procedure itself involves a greater risk of intra-operative haemorrhage.Elective caesarean hysterectomy using prophylactic bilateral internal iliac artery balloon occlusion offer an interesting approach which can minimize the risk of intra-operative haemorrhage. However, our case report describes the case of a 28-year old Gravida 3 Para 2 morbidly obese parturient diagnosed to have placenta previa type 3 posterior with accrete who experienced a complication of life threatening massive bleeding post-operatively after an elective caesarean hysterectomy using a prophylactic bilateral internal iliac artery balloon occlusion intra-operatively.

Interpregnancy Interval in Placenta Previa With Morbidly Adherent Placenta [15O]

2017 ◽  
Vol 129 ◽  
pp. S157
Author(s):  
Amir A. Shamshirsaz ◽  
Hadi Erfani ◽  
Bahram Salmanian ◽  
Karin A. Fox ◽  
Alex C. Vidaeff
Keyword(s):  
Placenta Previa ◽  
Interpregnancy Interval ◽  
Morbidly Adherent Placenta ◽  
Adherent Placenta
Sign in / Sign up

Export Citation Format

Share Document