Placenta accreta risk ‐ antepartum score (PAR‐A) in predicting clinical outcomes of placenta accreta spectrum: A multicenter validation study

2021 ◽  
Author(s):  
Sherif A. Shazly ◽  
Mohamed A. Anan ◽  
Tatiana B. Makukhina ◽  
Rauf Melekoglu ◽  
Farhat ul Ain Ahmed ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Validation Study ◽  
Placenta Accreta ◽  
Placenta Accreta Spectrum ◽  
Multicenter Validation

Clinical outcomes of a false positive antenatal diagnosis of placenta accreta spectrum

2021 ◽  
Author(s):  
Bahram Salmanian ◽  
Amir A. Shamshirsaz ◽  
Karin Fox ◽  
nazlisadat meshinchi asl ◽  
Hadi Erfani ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Resource Utilization ◽  
False Positive ◽  
Maternal Morbidity ◽  
Placenta Accreta ◽  
Antenatal Diagnosis ◽  
Estimated Blood Loss ◽  
Management Protocol ◽  
Significant Difference ◽  
Placenta Accreta Spectrum

Objective: Antenatal diagnosis of placenta accreta spectrum (PAS) is critical to reduce maternal morbidity. While clinical outcomes of women with PAS have been extensively described, little information is available regarding the women who undergo cesarean delivery with a presumptive PAS diagnosis which is not confirmed by histopathologic examination. We sought to examine resource utilization and clinical outcomes of this group of women with a false-positive diagnosis of PAS. Study design: Retrospective analysis of patients with prenatally diagnosed PAS cared for between 2015 and 2020 by our multidisciplinary PAS team. Maternal outcomes were examined. Univariate analysis was performed and a multivariate model was employed to compare outcomes between women with and without histopathologically confirmed PAS. Results: A total of 162 patients delivered with the pre-operative diagnosis of PAS. Of these, 146 (90%) underwent hysterectomy and had histopathologic confirmation of PAS. Thirteen women did not undergo the planned hysterectomy. Three women underwent hysterectomy but pathologic examination did not confirm PAS. In comparing women with and without pathologic confirmation of PAS, the false positive PAS group delivered later in pregnancy (34 vs. 33 weeks of gestation, P=0.015) and had more planned surgery (88% vs. 47%, P = 0.002). There was no difference in skin incision type or hysterotomy placement for delivery. No significant difference in either the estimated blood loss or blood components transfused was noted between groups. Conclusion: Careful intraoperative evaluation of women with pre-operatively presumed PAS resulted in a 3/149 (2%) retrospectively unnecessary hysterectomy. Management of women with PAS in experienced centers benefits patients both in terms of resource utilization and avoidance of unnecessary maternal morbidity, understanding that our results are produced in a center of excellence for PAS. We also propose a management protocol to assist in the avoidance of unnecessary hysterectomy in women with the pre-operative diagnosis of PAS.

scholarly journals The new pathology classification for placenta accreta spectrum is well associated with clinical outcomes

2022 ◽  
Vol 226 (1) ◽  
pp. S20
Author(s):  
Bahram Salmanian ◽  
Scott A. Shainker ◽  
Rachel D. Seaman ◽  
Anna M. Modest ◽  
Eumenia Castro ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Placenta Accreta ◽  
Pathology Classification ◽  
Placenta Accreta Spectrum

scholarly journals OC08.01: Placenta accreta spectrum prenatal ultrasound grade and association with clinical outcomes

2020 ◽  
Vol 56 (S1) ◽  
pp. 22-22
Author(s):  
H.C. Bartels ◽  
S.E. Craven ◽  
K.M. Mulligan ◽  
J. Donnelly ◽  
S.M. Corcoran ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Placenta Accreta ◽  
Prenatal Ultrasound ◽  
Placenta Accreta Spectrum
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