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- W3128790146 abstract "Low gestational sac implantation (LGSI) is an important marker for the diagnosis of placenta accreta spectrum (PAS) in the first trimester. Pregnancies with placenta previas but without PAS also have LGSI in early gestation. The objective of this study was to identify first trimester ultrasound markers to diagnose PAS in pregnancies with LGSI. This was a retrospective case-control study of pregnancies who delivered at our institution from 2009-2019. Cases represented pregnancies with PAS who delivered by cesarean-hysterectomy and had a first trimester ultrasound with LGSI. Controls represented pregnancies with persistent placenta previas without PAS, who delivered by cesarean-section without post-partum hemorrhage and had a first trimester ultrasound with LGSI. Sonographic images were reviewed by an investigator blinded to pregnancy outcome and sonography reports. Images were reviewed for presence of abnormal utero-placental interface, increased uterovesical hypervascularity, and placental lacunae, with or without swirling on gray scale or color Doppler. Definitions of ultrasound markers followed national task force on PAS. 21 cases and 46 controls met the inclusion criteria. Lacunae were present in 18/21 (85.7%) cases and in 7/46 (15.2%) controls (OR 33.4; 95% CI 7.7-144.4, p<.001). Presence of 3 or more lacunae were 100% predictive of PAS with an average of 5.0 lacunae in cases compared to 1.3 in controls (p=.019). The average size of the lacunae was 9.88±3.7mm in cases and 4.41±0.56 mm in controls (p<.001). Lacunae swirling on gray scale or color Doppler were 100% predictive of PAS (p<.001). Presence of an abnormal utero-placental interface was also 100% predictive of PAS (p<.001). Uterovesical hypervascularity was present in 14/14 cases and only 1/12 controls (p<.001). To our knowledge this is the first study evaluating the predictive value of PAS markers in early gestation in pregnancies with LGSI. In pregnancies with LGSI, presence of 3 or more lacunae or abnormal utero-placental interface in the first trimester is highly predictive of PAS." @default.
- W3128790146 created "2021-02-15" @default.
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- W3128790146 date "2021-02-01" @default.
- W3128790146 modified "2023-10-14" @default.
- W3128790146 title "172 Accuracy of ultrasound diagnosis of placenta accreta during the first trimester" @default.
- W3128790146 doi "https://doi.org/10.1016/j.ajog.2020.12.194" @default.
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