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- W2990191903 abstract "Objectives To explore whether early first-trimester ultrasound can predict the third-trimester sonographic stage of placenta accreta spectrum (PAS) disorder and to elucidate whether combining first-trimester ultrasound findings with the sonographic stage of PAS disorder can stratify the risk of adverse surgical outcome in women at risk for PAS disorder. Methods This was a retrospective analysis of prospectively collected data from women with placenta previa, and at least one previous Cesarean delivery (CD) or uterine surgery, for whom early first-trimester (5–7 weeks' gestation) ultrasound images could be retrieved. The relationship between the position of the gestational sac and the prior CD scar was assessed using three sonographic markers for first-trimester assessment of Cesarean scar (CS) pregnancy, reported by Calí et al. (crossover sign (COS)), Kaelin Agten et al. (implantation of the gestational sac on the scar vs in the niche of the CS) and Timor-Tritsch et al. (position of the center of the gestational sac below vs above the midline of the uterus), by two different examiners blinded to the final diagnosis and clinical outcome. The primary aim of the study was to explore the association between first-trimester ultrasound findings and the stage of PAS disorder on third-trimester ultrasound. Our secondary aim was to elucidate whether the combination of first-trimester ultrasound findings and sonographic stage of PAS disorder can predict surgical outcome. Logistic regression analysis and area under the receiver-operating-characteristics curve (AUC) were used to analyze the data. Results One hundred and eighty-seven women with vasa previa were included. In this cohort, 79.6% (95% CI, 67.1–88.2%) of women classified as COS-1, 94.4% (95% CI, 84.9–98.1%) of those with gestational-sac implantation in the niche of the prior CS and 100% (95% CI, 93.4–100%) of those with gestational sac located below the uterine midline, on first-trimester ultrasound, were affected by the severest form of PAS disorder (PAS3) on third-trimester ultrasound. On multivariate logistic regression analysis, COS-1 (odds ratio (OR), 7.9 (95% CI, 4.0–15.5); P < 0.001), implantation of the gestational sac in the niche (OR, 29.1 (95% CI, 8.1–104); P < 0.001) and location of the gestational sac below the midline of the uterus (OR, 38.1 (95% CI, 12.0–121); P < 0.001) were associated independently with PAS3, whereas parity (P = 0.4) and the number of prior CDs (P = 0.5) were not. When translating these figures into diagnostic models, first-trimester diagnosis of COS-1 (AUC, 0.94 (95% CI, 0.91–0.97)), pregnancy implantation in the niche (AUC, 0.92 (95% CI, 0.89–0.96)) and gestational sac below the uterine midline (AUC, 0.92 (95% CI, 0.88–0.96)) had a high predictive accuracy for PAS3. There was an adverse surgical outcome in 22/187 pregnancies and it was more common in women with, compared to those without, COS-1 (P < 0.001), gestational-sac implantation in the niche (P < 0.001) and gestational-sac position below the uterine midline (P < 0.001). On multivariate logistic regression analysis, third-trimester ultrasound diagnosis of PAS3 (OR, 4.3 (95% CI, 2.1–17.3)) and first-trimester diagnosis of COS-1 (OR, 7.9 (95% CI, 4.0–15.5); P < 0.001), pregnancy implantation in the niche (OR, 29.1 (95% CI, 8.1–79.0); P < 0.001) and position of the sac below the uterine midline (OR, 6.6 (95% CI, 3.9–16.2); P < 0.001) were associated independently with adverse surgical outcome. When combining the sonographic coordinates of the three first-trimester imaging markers, we identified an area we call high-risk-for-PAS triangle, which may enable an easy visual perception and application of the three methods to prognosticate the risk for CS pregnancy and PAS disorder, although it requires validation in large prospective studies. Conclusions Early first-trimester sonographic assessment of pregnancies with previous CD can predict reliably ultrasound stage of PAS disorder. Combination of findings on first-trimester ultrasound with second- and third-trimester ultrasound examination can stratify the surgical risk in women affected by a PAS disorder. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd." @default.
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- W2990191903 date "2020-04-01" @default.
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- W2990191903 title "Value of first‐trimester ultrasound in prediction of third‐trimester sonographic stage of placenta accreta spectrum disorder and surgical outcome" @default.
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- W2990191903 cites W1863104500 @default.
- W2990191903 cites W1898667567 @default.
- W2990191903 cites W1924482072 @default.
- W2990191903 cites W1941535056 @default.
- W2990191903 cites W1959256431 @default.
- W2990191903 cites W2043014538 @default.
- W2990191903 cites W2044470018 @default.
- W2990191903 cites W2079800508 @default.
- W2990191903 cites W2097523891 @default.
- W2990191903 cites W2105233945 @default.
- W2990191903 cites W2112133712 @default.
- W2990191903 cites W2146272590 @default.
- W2990191903 cites W2149472411 @default.
- W2990191903 cites W2156290650 @default.
- W2990191903 cites W2213022375 @default.
- W2990191903 cites W2237089326 @default.
- W2990191903 cites W2287548067 @default.
- W2990191903 cites W2470335107 @default.
- W2990191903 cites W2575620766 @default.
- W2990191903 cites W2590355110 @default.
- W2990191903 cites W2624038863 @default.
- W2990191903 cites W2728868636 @default.
- W2990191903 cites W2749158169 @default.
- W2990191903 cites W2757563419 @default.
- W2990191903 cites W2771053753 @default.
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- W2990191903 cites W2800611632 @default.
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- W2990191903 doi "https://doi.org/10.1002/uog.21939" @default.
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