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Accuracy of ultrasound in antenatal diagnosis of placental attachment disorders.
Pilloni, E; Alemanno, M G; Gaglioti, P; Sciarrone, A; Garofalo, A; Biolcati, M; Botta, G; Viora, E; Todros, T.
Afiliação
  • Pilloni E; Department of Obstetrics and Gynecology, University of Turin, Sant' Anna Hospital, Turin, Italy.
  • Alemanno MG; Department of Obstetrics and Gynecology, University of Turin, Sant' Anna Hospital, Turin, Italy.
  • Gaglioti P; Department of Obstetrics and Gynecology, University of Turin, Sant' Anna Hospital, Turin, Italy.
  • Sciarrone A; Department of Obstetrics and Gynecology, University of Turin, Sant' Anna Hospital, Turin, Italy.
  • Garofalo A; Department of Obstetrics and Gynecology, University of Turin, Sant' Anna Hospital, Turin, Italy.
  • Biolcati M; Department of Obstetrics and Gynecology, University of Turin, Sant' Anna Hospital, Turin, Italy.
  • Botta G; Department of Obstetrics and Gynecology, University of Turin, Sant' Anna Hospital, Turin, Italy.
  • Viora E; Department of Obstetrics and Gynecology, University of Turin, Sant' Anna Hospital, Turin, Italy.
  • Todros T; Department of Obstetrics and Gynecology, University of Turin, Sant' Anna Hospital, Turin, Italy.
Ultrasound Obstet Gynecol ; 47(3): 302-7, 2016 Mar.
Article em En | MEDLINE | ID: mdl-25964123
ABSTRACT

OBJECTIVES:

To evaluate the accuracy of ultrasound in the diagnosis of placenta accreta and its variants, and to assess the impact of prenatal diagnosis in our population.

METHODS:

A total of 314 women with placenta previa were enrolled prospectively and underwent transabdominal and transvaginal ultrasound examinations. An ultrasound diagnosis (grayscale and color/power Doppler) of placental attachment disorder (PAD) was based on the detection of at least two of the following ('two-criteria system') loss/irregularity of the retroplacental clear zone, thinning/interruption of the uterine serosa-bladder wall interface, turbulent placental lacunae with high velocity flow, myometrial thickness < 1 mm, increased vascularity of the uterine serosa-bladder wall interface, loss of vascular arch parallel to the basal plate and/or irregular intraplacental vascularization. Definitive diagnosis was made at delivery by Cesarean section. Maternal outcome in cases diagnosed antenatally was compared with that in cases diagnosed at delivery.

RESULTS:

There were 37/314 cases of PAD (29 anterior and eight posterior). The two-criteria system identified 30 cases of placenta accreta, providing a sensitivity of 81.1% and specificity of 98.9%. When anterior and posterior placentae were considered separately, the detection rates of PAD were 89.7 and 50.0%, respectIvely. Maternal outcome was better in women with prenatal diagnosis of PAD, as seen by less blood loss and shorter hospitalization.

CONCLUSIONS:

Our data confirmed that grayscale and color Doppler ultrasound have good performance in the diagnosis of PAD and that prenatal diagnosis improves maternal outcome. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Placenta Acreta / Diagnóstico Pré-Natal / Ultrassonografia Pré-Natal Tipo de estudo: Diagnostic_studies / Observational_studies / Prognostic_studies Limite: Adult / Female / Humans / Pregnancy Idioma: En Revista: Ultrasound Obstet Gynecol Assunto da revista: DIAGNOSTICO POR IMAGEM / GINECOLOGIA / OBSTETRICIA Ano de publicação: 2016 Tipo de documento: Article País de afiliação: Itália

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Placenta Acreta / Diagnóstico Pré-Natal / Ultrassonografia Pré-Natal Tipo de estudo: Diagnostic_studies / Observational_studies / Prognostic_studies Limite: Adult / Female / Humans / Pregnancy Idioma: En Revista: Ultrasound Obstet Gynecol Assunto da revista: DIAGNOSTICO POR IMAGEM / GINECOLOGIA / OBSTETRICIA Ano de publicação: 2016 Tipo de documento: Article País de afiliação: Itália