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Placenta Accreta Spectrum Prenatal Diagnosis Performance: Are Ultrasound False-positive Results Acceptable in Limited-resources Settings?

Objective  The immediate referral of patients with risk factors for placenta accreta spectrum (PAS) to specialized centers is recommended, thus favoring an early diagnosis and an interdisciplinary management. However, diagnostic errors are frequent, even in referral centers (RCs). We sought to evalu...

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Detalles Bibliográficos
Autores principales: Nieto-Calvache, Albaro José, Benavides-Calvache, Juan Pablo, Hidalgo, Alejandra, Padilla, Natalia, López-Tenorio, Jaime, Victoria, Alejandro, Rengifo, Martin, Mejía, Mauricio, Vergara-Galliadi, Lina María, Sinisterra-Díaz, Stiven Ernesto, Maya, Juliana, Zambrano, María Andrea, Burgos-Luna, Juan Manuel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Thieme Revinter Publicações Ltda. 2022
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9948072/
https://www.ncbi.nlm.nih.gov/pubmed/36067797
http://dx.doi.org/10.1055/s-0042-1751061
Descripción
Sumario:Objective  The immediate referral of patients with risk factors for placenta accreta spectrum (PAS) to specialized centers is recommended, thus favoring an early diagnosis and an interdisciplinary management. However, diagnostic errors are frequent, even in referral centers (RCs). We sought to evaluate the performance of the prenatal diagnosis for PAS in a Latin American hospital. Methods  A retrospective descriptive study including patients referred due to the suspicion of PAS was conducted. Data from the prenatal imaging studies were compared with the final diagnoses (intraoperative and/or histological). Results  A total of 162 patients were included in the present study. The median gestational age at the time of the first PAS suspicious ultrasound was 29 weeks, but patients arrived at the PAS RC at 34 weeks. The frequency of false-positive results at referring hospitals was 68.5%. Sixty-nine patients underwent surgery based on the suspicion of PAS at 35 weeks, and there was a 28.9% false-positive rate at the RC. In 93 patients, the diagnosis of PAS was ruled out at the RC, with a 2.1% false-negative frequency. Conclusion  The prenatal diagnosis of PAS is better at the RC. However, even in these centers, false-positive results are common; therefore, the intraoperative confirmation of the diagnosis of PAS is essential.