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Lower uterine segment placental thickness in women with abnormally invasive placenta.

Bhide, A; Laoreti, A; Kaelin Agten, A; Papageorghiou, A; Khalil, A; Uprichard, J; Thilaganathan, B; Chandraharan, E (2018) Lower uterine segment placental thickness in women with abnormally invasive placenta. Acta Obstet Gynecol Scand, 98 (1). pp. 95-100. ISSN 1600-0412 https://doi.org/10.1111/aogs.13422
SGUL Authors: Bhide, Amarnath Uprichard, James

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Abstract

Introduction Ultrasound signs of abnormal placental invasion are subjective in nature. We tested the hypothesis that placental thickness in the lower uterine segment is increased when there is abnormally invasive placenta (AIP) in women with a low‐lying placenta. Material and methods Retrospective analysis of data of placental thickness in women with ultrasound evidence of major placenta previa or a low‐lying anterior placenta was done. The diagnosis of AIP was confirmed both intraoperatively and on histopathology for those managed by partial myometrial excision with uterine conservation or by hysterectomy. Results In all, 131 records were available for analysis after exclusion of 33 cases due to unsuitable images and eight cases without pregnancy outcomes. The diagnosis of AIP was confirmed in 28 (21.4%) of the 131 cases. The lower segment placental thickness was significantly higher in women with AIP (median = 50.3 mm, IQR: 42.7‐64.3) than in those with normal placentation (median = 30.9 mm, IQR: 22.9‐42.2, P < 0.001). Logistic regression analysis showed that previous cesarean section and placental thickness on ultrasound were independent predictors for AIP. Conclusions Lower uterine segment placental thickness is increased in women with AIP compared with those with noninvasive placentation. This association constitutes a pragmatic objective sign and may be of clinical value in improving prenatal detection of AIP in women with placental implantation in the lower uterine segment. Prospective studies are necessary to ascertain lower segment placental thickness as a predictor for AIP.

Item Type: Article
Additional Information: This is the peer reviewed version of the following article: Bhide A, Laoreti A, Kaelin Agten A, et al. Lower uterine segment placental thickness in women with abnormally invasive placenta. Acta Obstet Gynecol Scand. 2019;98:95–100, which has been published in final form at https://doi.org/10.1111/aogs.13422. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.
Keywords: Abnormal invasive placenta, Placenta accreta, Placental thickness, Ultrasound, Obstetrics & Reproductive Medicine, 1114 Paediatrics And Reproductive Medicine, 1117 Public Health And Health Services
SGUL Research Institute / Research Centre: Academic Structure > Infection and Immunity Research Institute (INII)
Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Academic Structure > Molecular and Clinical Sciences Research Institute (MCS) > Vascular & Cardiac Surgery (INCCVC)
Journal or Publication Title: Acta Obstet Gynecol Scand
ISSN: 1600-0412
Language: eng
Dates:
DateEvent
18 December 2018Published
2 August 2018Published Online
6 July 2018Published Online
30 June 2018Accepted
Publisher License: Publisher's own licence
PubMed ID: 29978457
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/109964
Publisher's version: https://doi.org/10.1111/aogs.13422

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