Prevalence of sonographically detected fetal congenital malformations among cases of placenta accrete: a retrospective study
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20250838Keywords:
Placenta accreta, Fetal anomalies, Third trimester ultrasoundAbstract
Background: Placenta accreta spectrum (PAS) is well known cause of maternal morbidity and mortality. Its incidence had been increased obviously during the last two decades. Almost all literature about placenta accreta is about maternal complications and paucity about fetal ones. Objectives were to assess the prevalence of fetal anomalies detected sonographically in cases placenta accreta diagnosed at the third trimester.
Methods: Our study is a retrospective study that had carried on at one tertiary center (Habashy 4D scan center; Alexandria; Egypt). We collected cases that diagnosed as placenta accreta prenatally by ultrasound in the third trimester from January 2020 till December 2024. We had excluded twin, ICSI pregnancies and maternal age ≥37 years. After enrollment of these cases we had searched for the prevalence of major fetal anomalies recorded in their reports.
Results: We included 133 PAS cases in our study. Maternal age window was: 24-36 years. Gestational age range at their third trimester scanning was: 28-36 weeks. 2 out of the 133 fetuses (1.995%) were had major fetal anomaly which were; transposition of the great arteries (TGA) and bladder exstrophy (BE).
Conclusions: The prevalence of major fetal anomalies among cases of placenta accreta is 1.995% which is lower than that in non-accreta pregnancies. Further large-scale studies are needed to confirm our observation.
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References
Jauniaux E, Collins S, Burton GJ. Placenta accreta spectrum: pathophysiology and evidence-based anatomy for prenatal ultrasound imaging. Am J Obstet Gynecol. 2018;218(1):75-87. DOI: https://doi.org/10.1016/j.ajog.2017.05.067
Irving C, Hertig AT. A study of placenta accreta. Surg Gynecol Obstet. 1937;64:178-200.
Forster DS. A case of placenta accreta. Can Med Assoc J. 1927;17:204-7.
Hecht JL, Baergen R, Ernst LM, Katzman PJ, Jacques SM, Jauniaux E. Classification and reporting guidelines for the pathology diagnosis of placenta accreta spectrum (PAS) disorders: recommendations from an expert panel. Mod Pathol. 2020;33(12):2382-96. DOI: https://doi.org/10.1038/s41379-020-0569-1
Jauniaux E, Ayres-de-Campos D, Langhoff-Roos J, Fox KA, Collins S, Diagnosis FPA. Management expert consensus P. FIGO classification for the clinical diagnosis of placenta accreta spectrum disorders. Int J Gynaecol Obstet. 2019;146(1):20-4. DOI: https://doi.org/10.1002/ijgo.12761
Jauniaux E, Collins SL, Jurkovic D, Burton GJ. Accreta placentation. A systematic review of prenatal ultrasound imaging and grading of villous invasiveness. Am J Obstet Gynecol. 2016;215(6):712-21. DOI: https://doi.org/10.1016/j.ajog.2016.07.044
Collins SL, Ashcroft A, Braun T, Calda P, Langhoff-Roos J, Morel O, et al. European Working Group on Abnormally Invasive Placenta (EW-AIP). Proposal for standardized ultrasound descriptors of abnormally invasive placenta (AIP). Ultrasound Obstet Gynecol. 2016;47(3):271-5. DOI: https://doi.org/10.1002/uog.14952
Fonseca A, Ayres de Campos D. Maternal morbidity and mortality due to placenta accreta spectrum disorders. Best Pract Res Clin Obstet Gynaecol. 2021;72:84-91. DOI: https://doi.org/10.1016/j.bpobgyn.2020.07.011
Silver RM, Landon MB, Rouse DJ, Kenneth JL, Catherine YS, Elizabeth AT, et al. National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. Maternal morbidity associated with multiple repeat cesarean deliveries. Obstet Gynecol. 2006;107(6):1226-32. DOI: https://doi.org/10.1097/01.AOG.0000219750.79480.84
Viana Pinto P, Kawka-Paciorkowska K, Morlando M, Huras H, Kołak M, Bertholdt C, et al. Prevalence of fetal anomalies, stillbirth, neonatal morbidity, or mortality in pregnancies complicated by placenta accreta spectrum disorders. Acta Obstet Gynecol Scand. 2024;00:1-7. DOI: https://doi.org/10.1111/aogs.14919
Kancherla V, Räisänen S, Gissler M, Kramer MR, Heinonen S. Placenta previa and risk of major congenital malformations among singleton births in Finland. Birth Defects Res A Clin Mol Teratol. 2015;103(6):527-35. DOI: https://doi.org/10.1002/bdra.23371
Llurba Olive E, Xiao E, Natale DR, Fisher SA. Oxygen and lack of oxygen in fetal and placental development, feto-placental coupling, and congenital heart defects. Birth Defects Res. 2018;110(20):1517-30. DOI: https://doi.org/10.1002/bdr2.1430
Zhao H, Wong RJ, Stevenson DK. The Impact of Hypoxia in Early Pregnancy on Placental Cells. Int J Mol Sci. 2021;22(18):9675. DOI: https://doi.org/10.3390/ijms22189675
Shih JC, Kang J, Tsai SJ, Lee JK, Liu KL, Huang KY. The "rail sign": an ultrasound finding in placenta accreta spectrum indicating deep villous invasion and adverse outcomes. Am J Obstet Gynecol. 2021;225(3):292.e1. DOI: https://doi.org/10.1016/j.ajog.2021.03.018
Prevalence charts and tables | EU RD Platform. Available at: https://eu-rd-platform.jrc.ec.europa.eu/eurocat/eurocat-data/prevalence_en. Accessed on 25 December 2024.
Monier I, Lelong N, Benachi A, Jouannic JM, Khoshnood B, Zeitlin J. Postnatal diagnosis of congenital anomalies despite active systematic prenatal screening policies: a population-based registry study. Am J Obstet Gynecol MFM. 2023;5(11):101170. DOI: https://doi.org/10.1016/j.ajogmf.2023.101170
Bardi F, Bergman JEH, Siemensma-Mühlenberg N, Elvan-Taşpınar A, de Walle HEK, Bakker MK. Prenatal diagnosis and pregnancy outcome of major structural anomalies detectable in the first trimester: A population-based cohort study in the Netherlands. Paediatr Perinat Epidemiol. 2022;36(6):804-14. DOI: https://doi.org/10.1111/ppe.12914
Dulgheroff FF, Peixoto AB, Petrini CG, Caldas TMRDC, Ramos DR, Magalhães FO, et al. Fetal structural anomalies diagnosed during the first, second and third trimesters of pregnancy using ultrasonography: a retrospective cohort study. Sao Paulo Med J. 2019;137(5):391-400. DOI: https://doi.org/10.1590/1516-3180.2019.026906082019