Prenatal sonography can predict degree of placental invasion
K M Chalubinski, S Pils, K Klein, R Seemann, P Speiser, M Langer, J Ott, K M Chalubinski, S Pils, K Klein, R Seemann, P Speiser, M Langer, J Ott
Abstract
Objective: To evaluate whether the maximum degree of placental invasion (placenta accreta, increta or percreta) can be predicted with ultrasound imaging, using criteria developed in our department.
Methods: This was a retrospective study of all 232 patients at risk for placental invasion who were part of a routine screening program for placental invasion from January 2001 to January 2011. The whole placenta was scanned in a systematic manner using both gray-scale ultrasound and color-flow mapping. Sonographic findings were compared with the clinical outcome during and after delivery and the histomorphological examination of the placenta.
Results: Placental invasion was suspected by ultrasound in 40 (17.2%) patients and was clinically/histopathologically confirmed in a total of 35 (15.1%) patients. The sensitivity, specificity and positive and negative predictive values of ultrasound for placental invasion were 91.4% (95% CI, 77.6-97.0%), 95.9% (95% CI, 92.2-97.9%), 80.0% (95% CI, 65.2-89.5%) and 98.4% (95% CI, 95.5-99.5%), respectively. No case of placenta increta (n = 7) or percreta (n = 17) was diagnosed as showing normal placentation or placenta accreta on ultrasound, giving an overall accuracy for the differentiation between normal placentation/placenta accreta and placenta increta/percreta of 100%.
Conclusion: Our data suggest that prediction of the degree of placental invasion is possible using prenatal ultrasound, with high overall accuracy.
Keywords: antenatal; placenta accreta; placental invasion; predictive value; ultrasound.
Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd.
Source: PubMed