Prenatal sonographic diagnosis of placenta accreta--impact on maternal and neonatal outcomes.
Document Type
Article
Publication Date
10-1-2014
Institution/Department
Pathology; MMCRI; Obstetrics & Gynecology
Journal Title
Journal of clinical ultrasound : JCU
MeSH Headings
Adult, Female, Follow-Up Studies, Humans, Infant, Newborn, Male, Placenta Accreta, Pregnancy, Pregnancy Outcome, Retrospective Studies, Risk Factors, Time Factors, Ultrasonography, Prenatal
Abstract
PURPOSE: To compare maternal and neonatal outcomes of prenatally diagnosed versus undiagnosed cases of placenta accreta.
METHODS: This retrospective study included all pathology-proven placentas accreta/increta/percreta from a single tertiary center from January 1, 2005 to December 31, 2012. Outcomes were compared between prenatally diagnosed and undiagnosed cases.
RESULTS: Thirty-six cases of abnormal implantations were identified, of which 19 (53%) were prenatally diagnosed by ultrasound. Prenatal detection was more likely with a percreta (7/19 versus 2/17, p = .07), parity (18/19 versus 9/17, p = .01), prior cesarean (17/19 versus 4/17, p = .0001), shorter cesarean-conception interval (22.8 ± 21.4 versus 108 ± 7.6 months, p = .01), and spontaneous conception (19/19 versus 12/17, p = .03). Cases diagnosed prenatally more frequently received steroids for fetal maturity (13/20 versus 3/19, p = .003), delivered by cesarean (19/19 versus 11/17, p = .01) under general anesthesia (14/19 versus 4/17, p = .002) with a cell saver (5/19 versus 0/17, p = .06). There were no statistically significant differences by group in maternal blood loss, transfusion, intensive care admission or length of stay, operative injury, or severe composite morbidity (reoperation, coagulopathy, thromboembolism, wound infection, multiorgan failure, transfusion reaction, fistula, or chest compressions). There were no statistically significant differences in 5-minute Apgar
CONCLUSION: Prenatally undiagnosed accretas are less complex than prenatally diagnosed cases, but associated with statistically similar outcomes, suggesting benefit to prenatal recognition.
ISSN
1097-0096
First Page
449
Last Page
455
Recommended Citation
Hall, Tania; Wax, Joseph R; Lucas, F Lee; Cartin, Angelina; Jones, Michael; and Pinette, Michael G, "Prenatal sonographic diagnosis of placenta accreta--impact on maternal and neonatal outcomes." (2014). MaineHealth Maine Medical Center. 222.
https://knowledgeconnection.mainehealth.org/mmc/222