Clinical and Ultrasound Predictors of Placenta Accreta in Pregnant Women with Antepartum Diagnosis of Placenta Previa: A Multicenter Study

Gynecol Obstet Invest. 2019;84(3):242-247. doi: 10.1159/000494492. Epub 2018 Nov 16.

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.

Keywords: Antepartum diagnosis; Placenta accreta; Placenta previa; Risk factors; Ultrasound.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Cesarean Section / adverse effects
  • Cross-Sectional Studies
  • Female
  • Humans
  • Maternal Age
  • Placenta / blood supply
  • Placenta / diagnostic imaging
  • Placenta Accreta / diagnosis*
  • Placenta Accreta / diagnostic imaging
  • Placenta Accreta / epidemiology
  • Placenta Previa / diagnosis*
  • Pregnancy
  • Prenatal Diagnosis*
  • Risk Factors
  • Ultrasonography, Doppler
  • Ultrasonography, Prenatal