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Ultrasonographic Prediction of Placental Invasion in Placenta Previa by Placenta Accreta Index

This study aimed to investigate the diagnostic accuracy of the placenta accreta index (PAI) for predicting placenta accreta spectrum (PAS) in women with placenta previa. We analyzed 33 pregnancies with placenta previa at Keio University Hospital. The PAI was assessed in the early third trimester, an...

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Autores principales: Hasegawa, Keita, Ikenoue, Satoru, Tanaka, Yuya, Oishi, Maki, Endo, Toyohide, Sato, Yu, Ishii, Ryota, Kasuga, Yoshifumi, Ochiai, Daigo, Tanaka, Mamoru
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9918036/
https://www.ncbi.nlm.nih.gov/pubmed/36769741
http://dx.doi.org/10.3390/jcm12031090
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author Hasegawa, Keita
Ikenoue, Satoru
Tanaka, Yuya
Oishi, Maki
Endo, Toyohide
Sato, Yu
Ishii, Ryota
Kasuga, Yoshifumi
Ochiai, Daigo
Tanaka, Mamoru
author_facet Hasegawa, Keita
Ikenoue, Satoru
Tanaka, Yuya
Oishi, Maki
Endo, Toyohide
Sato, Yu
Ishii, Ryota
Kasuga, Yoshifumi
Ochiai, Daigo
Tanaka, Mamoru
author_sort Hasegawa, Keita
collection PubMed
description This study aimed to investigate the diagnostic accuracy of the placenta accreta index (PAI) for predicting placenta accreta spectrum (PAS) in women with placenta previa. We analyzed 33 pregnancies with placenta previa at Keio University Hospital. The PAI was assessed in the early third trimester, and PAS was diagnosed histologically or clinically defined as retained placenta after manual removal attempts. The PAI and incidence of PAS were analyzed. Ten women (30%) were diagnosed with PAS and had higher volumes of perioperative bleeding (p = 0.016), higher rate of requiring uterine artery embolization (p = 0.005), and peripartum hysterectomy (p = 0.0002) than women without PAS. A PAI > 2 was the most useful cut-off point for predicting PAS and was more sensitive than prediction values using traditional evaluation (history of cesarean section and placental location). Post-hoc analysis revealed a higher rate of previous history of cesarean delivery (30% vs. 4.4%, p = 0.038), severe placental lacunae (≥grade2) (70% vs. 8.7%, p = 0.0003), thin myometrial thickness (90% vs. 22%, p = 0.0003), anterior placenta (100% vs. 30%, p = 0.0002), and presence of bridging vessels (30% vs. 0%, p = 0.0059) in PAS women. PAI could help predict the outcomes of women with placenta previa with and without a history of cesarean delivery to reduce PAS-induced perinatal complications.
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spelling pubmed-99180362023-02-11 Ultrasonographic Prediction of Placental Invasion in Placenta Previa by Placenta Accreta Index Hasegawa, Keita Ikenoue, Satoru Tanaka, Yuya Oishi, Maki Endo, Toyohide Sato, Yu Ishii, Ryota Kasuga, Yoshifumi Ochiai, Daigo Tanaka, Mamoru J Clin Med Article This study aimed to investigate the diagnostic accuracy of the placenta accreta index (PAI) for predicting placenta accreta spectrum (PAS) in women with placenta previa. We analyzed 33 pregnancies with placenta previa at Keio University Hospital. The PAI was assessed in the early third trimester, and PAS was diagnosed histologically or clinically defined as retained placenta after manual removal attempts. The PAI and incidence of PAS were analyzed. Ten women (30%) were diagnosed with PAS and had higher volumes of perioperative bleeding (p = 0.016), higher rate of requiring uterine artery embolization (p = 0.005), and peripartum hysterectomy (p = 0.0002) than women without PAS. A PAI > 2 was the most useful cut-off point for predicting PAS and was more sensitive than prediction values using traditional evaluation (history of cesarean section and placental location). Post-hoc analysis revealed a higher rate of previous history of cesarean delivery (30% vs. 4.4%, p = 0.038), severe placental lacunae (≥grade2) (70% vs. 8.7%, p = 0.0003), thin myometrial thickness (90% vs. 22%, p = 0.0003), anterior placenta (100% vs. 30%, p = 0.0002), and presence of bridging vessels (30% vs. 0%, p = 0.0059) in PAS women. PAI could help predict the outcomes of women with placenta previa with and without a history of cesarean delivery to reduce PAS-induced perinatal complications. MDPI 2023-01-31 /pmc/articles/PMC9918036/ /pubmed/36769741 http://dx.doi.org/10.3390/jcm12031090 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Hasegawa, Keita
Ikenoue, Satoru
Tanaka, Yuya
Oishi, Maki
Endo, Toyohide
Sato, Yu
Ishii, Ryota
Kasuga, Yoshifumi
Ochiai, Daigo
Tanaka, Mamoru
Ultrasonographic Prediction of Placental Invasion in Placenta Previa by Placenta Accreta Index
title Ultrasonographic Prediction of Placental Invasion in Placenta Previa by Placenta Accreta Index
title_full Ultrasonographic Prediction of Placental Invasion in Placenta Previa by Placenta Accreta Index
title_fullStr Ultrasonographic Prediction of Placental Invasion in Placenta Previa by Placenta Accreta Index
title_full_unstemmed Ultrasonographic Prediction of Placental Invasion in Placenta Previa by Placenta Accreta Index
title_short Ultrasonographic Prediction of Placental Invasion in Placenta Previa by Placenta Accreta Index
title_sort ultrasonographic prediction of placental invasion in placenta previa by placenta accreta index
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9918036/
https://www.ncbi.nlm.nih.gov/pubmed/36769741
http://dx.doi.org/10.3390/jcm12031090
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