%0 Journal Article %1 juanclar2022effectiveness %A Juan-Clar, M. %A Torrent, M. %A Santandreu, P. %A Arejola, E. %A Ibarra, J. %A Tubau, A. %D 2022 %J Fetal Diagnosis and Therapy %K grapp-caib %N 1 %P 52--59 %R 10.1159/000521738 %T Effectiveness of Ultrasound Screening for a Placenta Accreta Spectrum Using Standard Ultrasound Criteria in a Secondary Care Setting %U https://www.karger.com/DOI/10.1159/000521738 %V 49 %X <b><i>Objectives:</i></b> Ultrasound detection of a placenta accreta spectrum (PAS) among women at risk is a key goal to reduce obstetric morbidity, but there is scarce information on its performance in real clinical settings. We report the effectiveness of a standardized ultrasound protocol to detect PAS in women with placenta previa (PP) in a secondary-level hospital. <b><i>Methods:</i></b> A retrospective analysis, including a cohort of 126 women with persistent PP among 27,975 pregnancies between 2008 and 2020, was performed. All 126 women underwent standardized transabdominal and transvaginal ultrasound scan that assessed 5 criteria: (1) loss of hypoechoic retroplacental zone and/or myometrial thinning &#x3c;1 mm; (2) lacunar images with a flow of &#x3e;15 cm/s; (3) thick and bulging placenta; (4) thinning or interruption of the uterine-bladder serous interface; and (5) placental or uterovesical hypervascularity. The presence of at least one criterion was considered a high risk for PAS. Diagnosis of PAS was confirmed during the caesarean section and by histopathological analysis. <b><i>Results:</i></b> Among 126 women with PP, 11 (8.7%) cases of PAS were diagnosed, of which 10 were detected prenatally by ultrasound scan. This resulted in a sensitivity of 90.9%, a specificity of 98.3%, a positive predictive value of 83.3%, and a negative predictive value of 99.1%. Histopathological assessment showed 6 placenta increta (54.5%), 4 percreta (36.4%), and 1 accreta (9.1%). All 10 cases of invasive placenta presented more than 3 ultrasound criteria. <b><i>Conclusions:</i></b> Standardized ultrasound screening protocol in women at risk due to PP in the third trimester was highly effective in detecting PAS in a secondary-level hospital setting.

@article{juanclar2022effectiveness, abstract = {<b><i>Objectives:</i></b> Ultrasound detection of a placenta accreta spectrum (PAS) among women at risk is a key goal to reduce obstetric morbidity, but there is scarce information on its performance in real clinical settings. We report the effectiveness of a standardized ultrasound protocol to detect PAS in women with placenta previa (PP) in a secondary-level hospital. <b><i>Methods:</i></b> A retrospective analysis, including a cohort of 126 women with persistent PP among 27,975 pregnancies between 2008 and 2020, was performed. All 126 women underwent standardized transabdominal and transvaginal ultrasound scan that assessed 5 criteria: (1) loss of hypoechoic retroplacental zone and/or myometrial thinning &#x3c;1 mm; (2) lacunar images with a flow of &#x3e;15 cm/s; (3) thick and bulging placenta; (4) thinning or interruption of the uterine-bladder serous interface; and (5) placental or uterovesical hypervascularity. The presence of at least one criterion was considered a high risk for PAS. Diagnosis of PAS was confirmed during the caesarean section and by histopathological analysis. <b><i>Results:</i></b> Among 126 women with PP, 11 (8.7%) cases of PAS were diagnosed, of which 10 were detected prenatally by ultrasound scan. This resulted in a sensitivity of 90.9%, a specificity of 98.3%, a positive predictive value of 83.3%, and a negative predictive value of 99.1%. Histopathological assessment showed 6 placenta increta (54.5%), 4 percreta (36.4%), and 1 accreta (9.1%). All 10 cases of invasive placenta presented more than 3 ultrasound criteria. <b><i>Conclusions:</i></b> Standardized ultrasound screening protocol in women at risk due to PP in the third trimester was highly effective in detecting PAS in a secondary-level hospital setting.}, added-at = {2022-05-11T15:57:24.000+0200}, author = {Juan-Clar, M. and Torrent, M. and Santandreu, P. and Arejola, E. and Ibarra, J. and Tubau, A.}, biburl = {https://www.bibsonomy.org/bibtex/24736a4849086efec16106634da512754/nachoricci}, description = {Effectiveness of Ultrasound Screening for a Placenta Accreta Spectrum Using Standard Ultrasound Criteria in a Secondary Care Setting - Abstract - Fetal Diagnosis and Therapy 2022, Vol. 49, No. 1-2 - Karger Publishers}, doi = {10.1159/000521738}, interhash = {8225658515016b0a29900e6bd9a26c4a}, intrahash = {4736a4849086efec16106634da512754}, issn = {10153837}, journal = {Fetal Diagnosis and Therapy}, keywords = {grapp-caib}, number = 1, pages = {52--59}, timestamp = {2022-05-11T15:57:24.000+0200}, title = {Effectiveness of Ultrasound Screening for a Placenta Accreta Spectrum Using Standard Ultrasound Criteria in a Secondary Care Setting}, url = {https://www.karger.com/DOI/10.1159/000521738}, volume = 49, year = 2022 }