Comparison of radiological imaging techniques for placenta accreta spectrum to optimise feto-maternal outcome by antenatal detection and management plan at a tertiary care centre
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20253532Keywords:
MRI, Feto-maternal outcome, Placenta accreta spectrum, SonographyAbstract
Background: Placenta accreta spectrum remains one of the most dangerous obstetric conditions especially when antenatal suspicion amounts to nil, resulting in severe feto-maternal outcomes. Therefore, accurate and optimal prenatal imaging is mandatory to instigate necessary preparation and strategic management approach.
Methods: We conducted a prospective study in our tertiary care centre, Punjab in duration of 18 months enrolling 54 antenatal patients fulfilling the inclusion criteria, reporting to the labour room by non-probability convenient sampling technique. Patients were subjected to radiological imaging (both ultrasonography and MRI) which was then followed by surgery. The data was analysed using suitable statistical software.
Results: We observed that patients with previous history of some surgery, be it caesarean section or D and C, pose a greater threat of acquiring placenta accreta syndrome and may tend to cause preterm births. Thus, requisiting antenatal diagnosis with the intent to ameliorate feto-maternal outcomes.
Conclusions: MRI has better diagnostic accuracy in terms of sensitivity and overall accuracy than sonography. Although cost and accessibility may limit the use of MRI, both aid in prenatal assessment and multi-disciplinary approach to help improve maternal and fetal outcome.
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References
Patel-Lippmann KK, Planz VB, Phillips CH, Ohlendorf JM, Zuckerwise LC, Moshiri M. Placenta accreta spectrum disorders: update and pictoral review of the SAR-ESUR joint consensus statement for MRI. Radiographics. 2023;43(5):e220090. DOI: https://doi.org/10.1148/rg.220090
Varlas VN, Bors RG, Birsanu S, Maxim B, Clotea E, Mihailov M. Maternal and fetal outcome in placenta accrete syndrome (PAS) associated with placenta previa:a retrospective analysis from a tertiary care centre. J Med Life. 2021;14(3):367-75. DOI: https://doi.org/10.25122/jml-2021-0134
Jansenarid CHJR, Kastelein AW, Kleinrouweler CE, Van Leeuwen E, De Jong KH, Pajkrt E, et al. Development of placental abnormalities in location and anatomy. Acta Obstet Gynecol Scand. 2020;99(8):983-93. DOI: https://doi.org/10.1111/aogs.13834
Baldwin HJ, Patterson JA, Nippita TA, Torvaldsen S, lbiebele I, Simpson JM, et al. Antecedents of abnormally invasive placenta in primiparous women: risk associated with gynecologic procedures. Obstet Gynecol. 2018;131(2):227-33. DOI: https://doi.org/10.1097/AOG.0000000000002434
American College of Obstetricians and Gynecologists; Society for Maternal-Fetal Medicine. Obstetric Care Consensus No. 7: Placenta Accreta Spectrum. Obstet Gynecol. 2018;132(6):259-75. DOI: https://doi.org/10.1097/AOG.0000000000002983
Rahimi-Sharbaf F, Jamal A, Mesdaghinia E, Abedzadeh-Kalahroudi M, Niroomanesh S, Atoof F. Ultrasound detection of placenta accreta in the first trimester of pregnancy. Iran J Reprod Med. 2014;12(6):421-6.
Borg HM, Ossman AM, Salem HA, El-Hemedi M, El-Shafie K, Alarabawya RA. Color Doppler ultrasound in diagnosis of placenta accreta. Evid Based Women’s Health J. 2018;8(3):215-22. DOI: https://doi.org/10.21608/ebwhj.2018.15471
Comstock CH, Bronsteen RA. The antenatal diagnosis of placenta accreta. BJOG. 2014;121:2. DOI: https://doi.org/10.1111/1471-0528.12557
Bartels HC, Doherty J, Curran M. Radiomics based prediction of FIGO grade for placenta accreta spectrum. Euro Radiol Exp. 2023;7:54. DOI: https://doi.org/10.1186/s41747-023-00369-2
Agostini TCF, Figueiredo R, Warmbrand G, Torres US, Pria HRFD, D’Ippolito G. Placental adhesion disorder: magnetic resonance imaging features and a proposal for a structured report. Radiol Bras. 2020;53(5):329-36. DOI: https://doi.org/10.1590/0100-3984.2019.0037
Srisajjakul S, Prapaisilp P, Bangchokdee S. Magnetic resonance imaging of placenta accreta spectrum: a step-by-step approach. Korean J Radiol. 2021;22(2):198-212. DOI: https://doi.org/10.3348/kjr.2020.0580
Agarwal S, Agarwal A, Chandak S. Role of placenta accreta index in prediction of morbidly adherent placenta: A reliability study. Ultrasound. 2021;29(2):92-9. DOI: https://doi.org/10.1177/1742271X20959742
Ye C, Ling L, Li S, Zhang Z, Zhang X. Comparisons of the diagnostic accuracy of the ultrasonic sign-score method and MRI for PA, PI and PP in high risk gravid women: a retrospective study. Am Transl Med. 2023;11(2):3-8. DOI: https://doi.org/10.21037/atm-22-6508
Jauniaux E, Bhide A. Prenatal ultrasound diagnosis and outcome of placenta previa accreta after caesarean delivery: a systematic review and meta analysis. Am J Obstet Gynecol. 2017;217:27-36. DOI: https://doi.org/10.1016/j.ajog.2017.02.050
Veludandi U, Suman BA, Nagamani S, Hothur M. Evaluation of outcome of pregnancy in placenta accrete spectrum. Int J reprod Contracept Obstet Gynecol. 2021;10(9):3331-5. DOI: https://doi.org/10.18203/2320-1770.ijrcog20213444
Shi XM, Whang Y, Zhang Y, Wei Y Chen L, Zhao YY. Effects of primary elective caesarean delivery on placenta accrete: a case control study. Chin Med J. 2018;131(6):672-6. DOI: https://doi.org/10.4103/0366-6999.226902
Srinivasan B, Balasubramanian N, Vijayaraghavan J, Joseph S, Rani U, Vishwanath U, et al. Study on outcomes of pregnancy in women with placenta accreta spectrum: a 10 year study in tertiary care center. J South Asian Feder Obstet Gynaecol. 2021;13(3):94-7. DOI: https://doi.org/10.5005/jp-journals-10006-1903
Thiravit S, Ma K, Goldman I, Chanprapaph P, Jha P, Daniel S, et al. Role of ultrasound and MRI in diagnosis of severe placenta accreta spectrum disorder: an individual assessment with emphasis on placental bulge. Am J Roentgenol. 2021;217(6):1377-88 DOI: https://doi.org/10.2214/AJR.21.25581
Cavalli C, Maggi C, Gambarini S, Fichera A, Santoro A, Grazioli L, et al. Ultrasound and magnetic resonance imaging in the diagnosis of clinically significant placenta accreta spectrum disorders. J Perinat Med. 2022;50(3):277-85. DOI: https://doi.org/10.1515/jpm-2021-0334
Lopes ES, Feitosa FE, Brazil AV, Castro JD, Costa JI, Araujo E, et al. Assessment of sensitivity and specificity of ultrasound and magnetic resonance imaging in the diagnosis of placenta accreta. Rev Bras Ginecol Obstet. 2019;41(01):17-23. DOI: https://doi.org/10.1055/s-0038-1675803
Khalek ME, Elhalaby AE, Elkhouly NI, Anter ME, Assaf HI. Menoufia University Hospital experience in management of the patients with morbidly adherent placenta. Menoufia Med J. 2020;33(2):480.
Tadayon M, Javadifar N, Dastoorpoor M, Shahbazian N. frequency, risk factors and pregnancy outcomes in cases with placenta accreta spectrum disorder: a case control study. J Reprod Infertil. 2022;23(4):279-87. DOI: https://doi.org/10.18502/jri.v23i4.10814
Imitiaz R, Masood Z, Husain S, lzhar R, Hussain S. A comparison of antenatally and intraoperatively diagnosed cases of placenta accreta spectrum. J Turk German Gynecol Assoc. 2020;21(2):84. DOI: https://doi.org/10.4274/jtgga.galenos.2019.2019.0063
Robinson BK, Grobrnan WA. Effectiveness of timing strategies for delivery of individuals with placenta previa and accreta. Obstet Gynecol. 2010;116(4):835-42 DOI: https://doi.org/10.1097/AOG.0b013e3181f3588d
Kasraeun M, Hashemi A, Hessami K, Alamdarloo SM, Vahdani R, Vafaei H, et al. A 5-year experience on perinatal outcome of placenta accreta spectrum disorder managed by caesarean hysterectomy in southern Iranian women. BMC Womens Health. 2021;21(1):243. DOI: https://doi.org/10.1186/s12905-021-01389-z