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Prenatal sonography can predict degree of placental invasion
Author(s) -
Chalubinski K. M.,
Pils S.,
Klein K.,
Seemann R.,
Speiser P.,
Langer M.,
Ott J.
Publication year - 2013
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1002/uog.12451
Subject(s) - placenta accreta , medicine , placentation , placenta , placenta percreta , obstetrics , ultrasound , gynecology , hysterectomy , retrospective cohort study , placenta diseases , pregnancy , prenatal diagnosis , radiology , fetus , surgery , biology , genetics
Objective To evaluate whether the maximum degree of placental invasion (placenta accreta, increta or percreta) can be predicted with ultrasound imaging, using criteria developed in our department . Methods This was a retrospective study of all 232 patients at risk for placental invasion who were part of a routine screening program for placental invasion from January 2001 to January 2011. The whole placenta was scanned in a systematic manner using both gray‐scale ultrasound and color‐flow mapping. Sonographic findings were compared with the clinical outcome during and after delivery and the histomorphological examination of the placenta . Results Placental invasion was suspected by ultrasound in 40 (17.2%) patients and was clinically/histopathologically confirmed in a total of 35 (15.1%) patients. The sensitivity, specificity and positive and negative predictive values of ultrasound for placental invasion were 91.4% (95% CI , 77.6–97.0%), 95.9% (95% CI , 92.2–97.9%), 80.0% (95% CI , 65.2–89.5%) and 98.4% (95% CI , 95.5–99.5%), respectively. No case of placenta increta ( n = 7) or percreta ( n = 17) was diagnosed as showing normal placentation or placenta accreta on ultrasound, giving an overall accuracy for the differentiation between normal placentation/placenta accreta and placenta increta/percreta of 100% . Conclusion Our data suggest that prediction of the degree of placental invasion is possible using prenatal ultrasound, with high overall accuracy. Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd .