Yan Li1, Hailey H Choi1, Ruth Goldstein1, Liina Poder1, Priyanka Jha2. 1. Department of Radiology and Biomedical Imaging, University of California, 505 Parnassus Ave, Box 0628, San Francisco, CA, 94143, USA. 2. Department of Radiology and Biomedical Imaging, University of California, 505 Parnassus Ave, Box 0628, San Francisco, CA, 94143, USA. Priyanka.Jha@ucsf.edu.
Abstract
OBJECTIVE: To evaluate the association of placental thickness with placenta accreta spectrum disorder in placenta previa. METHODS: In this IRB-approved, retrospective study, ultrasound (US) reports were retrospectively queried for keyword previa. US performed closest to mid-gestation were included. Three measurements were performed at the thickest portion of the placenta on longitudinal transabdominal images. Operative reports and surgical pathology were used as the reference standard. Statistical analysis was performed using unpaired T-tests and receiver operating curve (ROC) analysis. RESULTS: Sixty-five patients with placenta previa were included: 38 with PAS disorder and 27 without PAS disorder, clinically or pathologically. 38/38 (100%) patients of PAS group and 16/27 (59.3%) patients of non-PAS group had history of prior cesarean section. The average placental thickness was 4.3 cm (range 1.8 cm to 7.8 cm) for PAS group and 3.0 cm (range 0.6 cm to 5.3 cm) for non-PAS group (p < 0.001). Placental thickness in patients without PAS disorder and history of prior cesarean section was 3.1 (± 1.1) cm. This was statistically different from patients who had history of prior cesarean section with PAS diagnosis (4.3 cm, P<0.01). Using ROC analysis, a threshold measurement of 4.5 cm leads to sensitivity of 50% and specificity of 96%. CONCLUSION: Our results demonstrate that among women with placenta previa, increased placental thickness at lower uterine segment correlates with placenta accreta spectrum disorder. A threshold of 4.5 cm can be useful for screening patients with placenta previa and risks factors for PAS.
OBJECTIVE: To evaluate the association of placental thickness with placenta accreta spectrum disorder in placenta previa. METHODS: In this IRB-approved, retrospective study, ultrasound (US) reports were retrospectively queried for keyword previa. US performed closest to mid-gestation were included. Three measurements were performed at the thickest portion of the placenta on longitudinal transabdominal images. Operative reports and surgical pathology were used as the reference standard. Statistical analysis was performed using unpaired T-tests and receiver operating curve (ROC) analysis. RESULTS: Sixty-five patients with placenta previa were included: 38 with PAS disorder and 27 without PAS disorder, clinically or pathologically. 38/38 (100%) patients of PAS group and 16/27 (59.3%) patients of non-PAS group had history of prior cesarean section. The average placental thickness was 4.3 cm (range 1.8 cm to 7.8 cm) for PAS group and 3.0 cm (range 0.6 cm to 5.3 cm) for non-PAS group (p < 0.001). Placental thickness in patients without PAS disorder and history of prior cesarean section was 3.1 (± 1.1) cm. This was statistically different from patients who had history of prior cesarean section with PAS diagnosis (4.3 cm, P<0.01). Using ROC analysis, a threshold measurement of 4.5 cm leads to sensitivity of 50% and specificity of 96%. CONCLUSION: Our results demonstrate that among women with placenta previa, increased placental thickness at lower uterine segment correlates with placenta accreta spectrum disorder. A threshold of 4.5 cm can be useful for screening patients with placenta previa and risks factors for PAS.
Authors: R S Smith; M R Lauria; C H Comstock; M C Treadwell; J S Kirk; W Lee; S F Bottoms Journal: Ultrasound Obstet Gynecol Date: 1997-01 Impact factor: 7.299
Authors: M R Lauria; R S Smith; M C Treadwell; C H Comstock; J S Kirk; W Lee; S F Bottoms Journal: Ultrasound Obstet Gynecol Date: 1996-11 Impact factor: 7.299