Davide De Vita1, Giampiero Capobianco2, Giovanni Gerosolima3, Carmen Sciorio4, Ermenegilda Coppola4, Fabio Parazzini5, Maurizio Silvestri6, Anna Paola Caruso7, Maddalena Morlando8,9, Raffaele Petta10, Alessandro Pascarella11, Salvatore Dessole12, Elsa Viora13. 1. Department of Obstetric and Gynaecology, Hospital "A. Rizzoli", Ischia, Naples, Italy. 2. Gynecologic and Obstetric Clinic, Department of Medical, Surgical and Experimental Medicine, University of Sassari, Sassari, Italy, capobia@uniss.it. 3. Department of Obstetrics and Gynaecology, "San Giuseppe Moscati Hospital", Avellino, Italy. 4. Department of Obstetrics and Gynaecology, ASL Napoli 2 Nord, Naples, Italy. 5. Department of Clinical Sciences and Community, University of Milan, IRCCS Policlinico, Milan, Italy. 6. Gynecologic and Obstetric Clinic, Spoleto Hospital, Spoleto, Italy. 7. Department of Obstetrics and Gynaecology, Hospital of Cosenza, Cosenza, Italy. 8. Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy. 9. Department of Women, Children and of General and Specialized Surgery, University "Luigi Vanvitelli", Naples, Italy. 10. Department of Obstetrics and Gynaecology, "S.Giovanni di Dio e Ruggi d'Aragona Hospital", Salerno, Italy. 11. Department of Obstetrics and Gynaecology, Evangelic Hospital "Villa Betania", Naples, Italy. 12. Gynecologic and Obstetric Clinic, Department of Medical, Surgical and Experimental Medicine, University of Sassari, Sassari, Italy. 13. Department of Obstetrics and Gynecology, Obstetrical-Gynecological Ultrasound Unit, "Sant'Anna Hospital", Turin, Italy.
Abstract
BACKGROUND/AIMS: Abnormally invasive placenta (AIP) includes placenta accreta, increta, and percreta and represents major complications of pregnancy. This study was designed to assess the role of ultrasonography in the identification of AIP among pregnant women with antepartum diagnosis of placenta previa. METHODS: A cross-sectional study was performed between May 2015 and April 2016 in 11 centers, including 242 women with antepartum diagnosis of placenta previa. RESULTS: Ninety-eight out of 242 (40.49%) women had a histological diagnosis of placenta accreta. A higher number of caesarean deliveries (p = 0.001) and curettages (p = 0.027) and older age of the woman at the delivery (p = 0.031) were identified as risk factors for placenta accreta. The presence of irregularly shaped placental lacunae (vascular spaces) within the placenta (p = 0.008), protrusion of the placenta into the bladder (p < 0.0001), and turbulent blood flow through the lacunae on Doppler ultrasonography (p = 0.008) were predictors of placenta accreta. CONCLUSIONS: Women with a prior delivery by caesarean section have a high incidence of placenta accreta among women with antepartum diagnosis of placenta previa.
BACKGROUND/AIMS: Abnormally invasive placenta (AIP) includes placenta accreta, increta, and percreta and represents major complications of pregnancy. This study was designed to assess the role of ultrasonography in the identification of AIP among pregnant women with antepartum diagnosis of placenta previa. METHODS: A cross-sectional study was performed between May 2015 and April 2016 in 11 centers, including 242 women with antepartum diagnosis of placenta previa. RESULTS: Ninety-eight out of 242 (40.49%) women had a histological diagnosis of placenta accreta. A higher number of caesarean deliveries (p = 0.001) and curettages (p = 0.027) and older age of the woman at the delivery (p = 0.031) were identified as risk factors for placenta accreta. The presence of irregularly shaped placental lacunae (vascular spaces) within the placenta (p = 0.008), protrusion of the placenta into the bladder (p < 0.0001), and turbulent blood flow through the lacunae on Doppler ultrasonography (p = 0.008) were predictors of placenta accreta. CONCLUSIONS:Women with a prior delivery by caesarean section have a high incidence of placenta accreta among women with antepartum diagnosis of placenta previa.