scholarly journals Value of Crystal Vue technique in detecting the placenta accreta spectrum located in c-section scar area

2020 ◽  
Vol 22 (4) ◽  
pp. 438
Author(s):  
Shaoqi Chen ◽  
Qingzi Chen ◽  
Xiya Du ◽  
Sumin Chen ◽  
Weiping Li ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Pregnant Women ◽  
Placenta Accreta ◽  
Scar Area ◽  
Life Threatening ◽  
Postoperative Diagnosis ◽  
2D Ultrasound ◽  
Placenta Accreta Spectrum ◽  
Placental Invasion ◽  
Strong Suspicion

Aims: Excessive placental invasion is a life-threatening obstetric disease. Determining the extent of placental villi invasion prenatally is crucial for formulating a surgical plan for pregnant women. The objective of this study was to explore the diagnostic accuracy of the Crystal Vue technique combined with two-dimensional (2D) ultrasound in detecting the degree of placenta accreta spectrum (PAS) located in the C-section scar area.Materials and methods: Twenty-seven pregnant women with a strong suspicion of PAS underwent 2D ultrasound combined with a Crystal Vue examination. The diagnosis of 2D ultrasound alone and Crystal Vue combined with 2D ultrasound was statistically calculated, respectively. Cohen’s kappa (k) was used to measure the consistency between these two ultrasound diagnosis and the postoperative diagnosis.Results: The postoperative diagnosis of 27 pregnant women was as follows: 6 cases of placental accreta, 11 cases of placental increta, 2 cases of placental percreta, 2 cases of placental accrete and placental increta, 2 cases of placental accreta and placental percreta, and 4 cases without PAS. Compared with the postoperative diagnosis, 20 cases (74.07%) were correctly diagnosed by 2D ultrasound alone, 6 cases were misdiagnosed, and one case the diagnosis was incomplete, which were substantially consistent with the postoperative diagnosis (k=0.612, p<0.01). Twenty-six cases (96.30%) were correctly diagnosed by Crystal Vue combined with 2D ultrasound; only one case was incomplete diagnosed which was  almost perfectly consistent with the postoperative diagnosis (k=0.934, p<0.01).Conclusions: Combining the Crystal Vue technique with 2D ultrasound can improve the diagnostic accuracy of ultrasound for detecting all types of PAS located in C-section scar area. 

Sonographic Association Of Placenta Accreta Spectrum In Patients Of Placenta Previa-A Systematic Review

2021 ◽  
Vol 15 (11) ◽  
pp. 3050-3053
Author(s):  
Maida Saadat ◽  
Muhammad Mawaz Anjum ◽  
Faiza Farooq ◽  
Rehan Aslam Gill ◽  
Abeer Yasin ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Meta Analysis ◽  
Retrospective Case ◽  
Standard Methods ◽  
Placenta Accreta Spectrum ◽  
The Difference ◽  
Obstetric Population ◽  
High Level

Aim: To determine the diagnostic accuracy and epidemiology of placenta accreta spectrum (PAS) in patients of placenta previa. Methods: PubMed, Google Scholar, ClinicalTrials.gov and MEDLINE were searched between January1992 and December 2020. Studies on placenta previa complicated by PAS diagnosed in a defined obstetric population. This research was carried out using standard methods and protocols and keeping in view Newcastle-Ottawa scale for observation and assessment of case study along with the difference approved by consensus. The overall diagnostic accuracy of ultrasonographic findings is the main outcome of this study, whereas the prevalence of placenta accreta in patients of placenta previa and its incidence among different countries all over the world is also described. Results: In this review study, about 300 articles were evaluated. More over about 15 prospective and 14 retrospective case studies incorporated for assessment having complication with placenta previa and PAS. According to the meta-analysis, a significant (p<0.001) heterogeneity was found between case research that evaluate PAS prevalence and incidence in the placenta previa cohort. The median prevalence in case of placenta previa along with PAS came out to be 0.113% (IQR 0.048–0.17).Whereas incidence in females having placenta previa along with complication of PAS came out to be 11.3%. Conclusions: The high level of diversity observed in results obtained by diagnostic and qualitative data showed strong emphasis should be made on implementation of standard methods and protocols for assessment and diagnosis of pregnancy complication like placenta previa, its type and PAS. Keywords: Sonography placenta previa, placenta accreta spectrum

Circulating CD31+ Exosomes are Significantly Elevated with a Proliferative and Angiogenic but Anti-apoptotic mRNA Signature in Pregnant Women with Placenta Accreta Spectrum

Placenta ◽  
2019 ◽  
Vol 83 ◽  
pp. e14-e15
Author(s):  
Qian-Rong Qi ◽  
Josh Makhoul ◽  
Thomas Lechuga ◽  
A. Al-Khan ◽  
Nick Illsley ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Placenta Accreta ◽  
Placenta Accreta Spectrum

Intraplacental Fetal Vessel Diameter May Help Predict for Placental Invasiveness in Pregnant Women at High Risk for Placenta Accreta Spectrum Disorders

Radiology ◽  
2020 ◽  
pp. 200273 ◽  
Author(s):  
Charis Bourgioti ◽  
Anastasia Evangelia Konstantinidou ◽  
Konstantina Zafeiropoulou ◽  
Aristeidis Antoniou ◽  
Stavros Fotopoulos ◽  
...  
Keyword(s):  
High Risk ◽  
Pregnant Women ◽  
Placenta Accreta ◽  
Vessel Diameter ◽  
Placenta Accreta Spectrum ◽  
Spectrum Disorders ◽  
Fetal Vessel

Prenatal planning of placenta previa: diagnostic accuracy of a novel MRI-based prediction model for placenta accreta spectrum (PAS) and clinical outcome

2019 ◽  
Vol 44 (5) ◽  
pp. 1873-1882 ◽  
Author(s):  
Andrea Delli Pizzi ◽  
Alessandra Tavoletta ◽  
Roberta Narciso ◽  
Domenico Mastrodicasa ◽  
Stefano Trebeschi ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Diagnostic Accuracy ◽  
Prediction Model ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Placenta Accreta Spectrum

scholarly journals Conditions that increase the risk of cesarean-related blood transfusions: a single-center cohort study

2021 ◽  
Vol 29 (3) ◽  
pp. 210-216
Author(s):  
Mehmet Murat Işıkalan ◽  
Eren Berkay Özkaya ◽  
Buşra Özkaya ◽  
Nurullah Şengül ◽  
Enes Ferlibaş ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Pregnant Women ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Uterine Fibroids ◽  
University Hospital ◽  
Preoperative Anemia ◽  
Multiple Gestations ◽  
Anemia During Pregnancy ◽  
Placenta Accreta Spectrum

Objective This study aimed to define the conditions that increase the possibility of receiving a blood transfusion in patients who had a cesarean section. Methods This study was conducted between January 2016 – May 2020 in a university hospital located in Konya, Turkey. Pregnant women undergoing cesarean section were included. Of 4303 eligible patients, 188 women were the transfused group and 4115 women were the non-transfused group. Logistic regression analysis was performed for potential confounding factors. Results A total of 4303 eligible patients were evaluated in this study. There were 4115 patients (95.6%) in the non-transfused group. The transfused group consisted of 188 patients (4.4%). The probability of transfusion was higher in pregnant women with placenta previa, placenta accreta spectrum, thrombocytopenia, preoperative anemia, macrosomia above 4500 g, and multiple gestations [adjusted OR values (95% CI); 10.58 (range 4.75–23.57), 7.75 (range 3.22–18.61), 7.85 (range 3.46–17.79), 5.71 (range 4.21–7.74), 4.22 (range 1.21-14.67) and 2.10 (range 1.18-3.72), respectively]. There was no increase in the possibility of transfusion in 4000–4500 gram macrosomia, uterine fibroids, preeclampsia, premature rupture of membranes, previous cesarean sections and gestational diabetes mellitus. Conclusion Placenta previa, placenta accreta spectrum, thrombocytopenia, preoperative anemia, macrosomia above 4500 g and multiple gestations increase the possibility of transfusion. Perioperative blood preparation is vital in such patients. Prevention of anemia during pregnancy is critical in reducing transfusions.

Surgery for Uterine Preservation in Placenta Accreta Spectrum: A Retrospective Cohort Study

2021 ◽  
Author(s):  
Yi-Lei Li ◽  
Tao Li ◽  
Wen Peng ◽  
Xiang-Bin Liu ◽  
Hong-Mei Wang
Keyword(s):  
Blood Loss ◽  
Placenta Accreta ◽  
Psychological Trauma ◽  
Uterine Preservation ◽  
Cesarean Scar ◽  
Estimated Blood Loss ◽  
Placenta Accreta Spectrum ◽  
Placental Invasion ◽  
Cervical Involvement ◽  
Surgery Duration

Abstract Background: Owing to high risks of maternal morbidity, surgical complications, and loss of fertility, including psychological trauma caused by cesarean hysterectomy, innovative approaches for uterine preservation have been investigated. This study aimed to determine the efficacy of a novel eight-step surgical protocol for uterine preservation in placenta accreta spectrum (PAS) overlying the previous cesarean scar.Methods: We retrospectively studied consecutive patients with PAS overlying the cesarean scar, who were treated between December 2015 and October 2019 using the protocol. The depth and extension of placental invasion and severity of pelvic adhesion were assessed intraoperatively. Information regarding the gestational week at surgery, surgery duration, estimated blood loss (EBL), bladder injury, and post-procedural recovery was retrieved from the hospital database. Multiple linear regression was used to analyze factors influencing surgical blood loss. EBL was compared between the perioperative aortic balloon and non-balloon groups in severe cases using t-tests.Results: Overall, 115 patients with PAS were included. The mean EBL and surgery duration were 1666.1±1379.0 mL and 2.2±0.8 h, respectively. The uterus was successfully preserved in all patients with one surgery. Incidences of placenta accreta, increta, and percreta were 40 (35.8%), 46 (40.0%), and 29 (25.2%) cases, respectively. Extensive placental invasion and cervical involvement were observed in 41.7% and 28.7% of patients, respectively. EBL was significantly correlated with the extent of placental invasion, cervical involvement, and pelvic adhesion. No difference was seen in EBL between the balloon and non-balloon groups among the 44 patients with severe PAS.Conclusion: The eight-step protocol is effective for uterine preservation in PAS overlying the cesarean scar. EBL is affected by the extent of placental invasion, cervical involvement, and severity of pelvic adhesion. Perioperative aortic balloon should be used conservatively.

Resurgence of classical caesarean section in current obstetric practice- A case series

2021 ◽  
Vol 8 (4) ◽  
pp. 592-594
Author(s):  
Priyanka Mathe ◽  
Sanjana Narula Wadhwa ◽  
Taru Gupta
Keyword(s):  
Multidisciplinary Approach ◽  
Placenta Accreta ◽  
Case Series ◽  
Cesarean Sections ◽  
Obstetric Hemorrhage ◽  
Maternal Morbidity And Mortality ◽  
Life Threatening ◽  
Placenta Accreta Spectrum ◽  
High Index Of Suspicion ◽  
Lower Segment Uterine

Although, the incidence of placenta accreta spectrum (PAS) and large fibroids is rare but still these cases contributes to a large number of maternal morbidity and mortality. Major obstetric hemorrhage is one the dreadful complication of these types of cases and thus early diagnosis and intervention in such cases helps the physician to minimize the risk to mother and the fetus. Also, current widespread use of ultrasound has helped us to manage these cases judiciously, predict and prevent life threatening obstetric hemorrhage. Here we present three complicated obstetric cases of placenta accreta, large lower segment uterine fibroid and large cervical fibroid which necessitated classical cesarean sections (CCS) thus emphasizing prowess in CCS in modern obstetric era. High index of suspicion, Multidisciplinary approach alongwith expert surgical personnel should be available in high risks cases like placenta accreta syndrome and large fibroids in pregnancy.

Sign in / Sign up

Export Citation Format

Share Document