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Accuracy of ultrasound for the prediction of placenta accreta

Accuracy of ultrasound for the prediction of placenta accreta See related editorial, page 87 </P>Placenta accreta is defined as an abnormal adherence of placental villi to underlying myometrium with an absence of decidua basalis. Failure to anticipate placenta accreta and prepare for its appropriate management can lead to emergency hysterectomy with profuse, life-threatening hemorrhage, 1,2 disseminated coagulopathy, renal failure, acute respiratory distress, or even death. 3 Additional surgical complications include cystotomy, ureteral injury, infection, venous thromboembolism or prolonged hospitalization. 4-6 Accurate antenatal diagnosis of placenta accreta can allow arrangements to be made for a planned delivery at a tertiary care center utilizing a multidisciplinary approach, which has been shown to significantly reduce maternal morbidity. 5-7 </P>As the incidence of placenta accreta increases concurrently with an increased incidence of cesarean delivery, 1,4,8,9 patients and providers are more frequently confronted with difficult decisions such as whether to plan for a scheduled hysterectomy or to transfer care to a tertiary care center. With its implications for surgical morbidity and future fertility, this is not a decision taken lightly.</P>Placenta previa and history of prior cesarean delivery remain the most important predictors of placenta accreta. 4 In addition to clinical risk factors, ultrasound is often used antenatally as an adjunct to clinical http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Obstetrics and Gynecology Wolters Kluwer Health

Accuracy of ultrasound for the prediction of placenta accreta

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References (28)

Publisher
Wolters Kluwer Health
Copyright
Copyright © 2014 Mosby, Inc.
ISSN
0002-9378
DOI
10.1016/j.ajog.2014.03.029
pmid
24631709
Publisher site
See Article on Publisher Site

Abstract

See related editorial, page 87 </P>Placenta accreta is defined as an abnormal adherence of placental villi to underlying myometrium with an absence of decidua basalis. Failure to anticipate placenta accreta and prepare for its appropriate management can lead to emergency hysterectomy with profuse, life-threatening hemorrhage, 1,2 disseminated coagulopathy, renal failure, acute respiratory distress, or even death. 3 Additional surgical complications include cystotomy, ureteral injury, infection, venous thromboembolism or prolonged hospitalization. 4-6 Accurate antenatal diagnosis of placenta accreta can allow arrangements to be made for a planned delivery at a tertiary care center utilizing a multidisciplinary approach, which has been shown to significantly reduce maternal morbidity. 5-7 </P>As the incidence of placenta accreta increases concurrently with an increased incidence of cesarean delivery, 1,4,8,9 patients and providers are more frequently confronted with difficult decisions such as whether to plan for a scheduled hysterectomy or to transfer care to a tertiary care center. With its implications for surgical morbidity and future fertility, this is not a decision taken lightly.</P>Placenta previa and history of prior cesarean delivery remain the most important predictors of placenta accreta. 4 In addition to clinical risk factors, ultrasound is often used antenatally as an adjunct to clinical

Journal

American Journal of Obstetrics and Gynecology – Wolters Kluwer Health

Published: Aug 1, 2014

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