■胎盘植入谱(PAS)障碍被定义为胎盘的病理性粘附/侵入的范围。使用超声多普勒对PAS疾病进行产前诊断可以优化胎儿结局并减少并发症。
■研究产前超声分期系统对胎盘植入谱的存在和严重程度的预测价值及其与胎儿结局的相关性。
这是一项在VMMC和Safdarjung医院妇产科进行的前瞻性队列研究,新德里,为期18个月。它包括50名单胎妊娠>28周的前置胎盘伴瘢痕子宫的女性,在获得知情同意和伦理委员会批准后。所有女性均接受超声检查,并分配PAS评分,与术中FIGO等级相关,组织病理学和胎儿结局。
■在50名注册的女性中,进行产前超声分期,并分配PAS评分0,1,2和3.所有21名(42%)PAS评分>0(PAS1、2、3)的妇女都需要剖宫产子宫切除术。术中,局灶性和完全侵袭分别为4%和38%,分别,在46%中观察到FIGO等级1、2、3、4、5和6,16%,30%,0%,6%和2%,分别。在组织病理学上,14.28%(3/21)PAS>0没有任何入侵,而85.71%(18/21)有入侵,即,accreta,57.14%的增量和percreta,19.05%和9.52%,分别。以组织病理学为黄金标准,整体灵敏度,特异性,PPV,PAS评分的NPV和诊断准确率均为100%,90.62%,85.71%,100%和94%,分别。
■产前超声分期系统是一种简单可行的筛查方式。因此,所有前置胎盘和瘢痕子宫的高危妇女均应使用该方法进行明确的产前诊断。
UNASSIGNED: Placenta accreta spectrum (PAS) disorders are defined as range of pathological adherence/invasion of placenta. Prenatal diagnosis of PAS disorders using ultrasound doppler can optimize fetomaternal outcome and reduce complications.
UNASSIGNED: To study the predictive value of prenatal ultrasound staging system for the presence and severity of placenta accreta spectrum and its correlation with fetomaternal outcomes.
UNASSIGNED: This was a prospective cohort study conducted in Obstetrics and Gynecology department at VMMC and Safdarjung Hospital, New Delhi, over a period of 18 months. It included 50 women with singleton pregnancy > 28 weeks with placenta previa with scarred uterus after taking informed consent and ethics committee approval. All the women underwent ultrasound and PAS score was assigned, which was correlated with intraoperative FIGO grade, histopathology and fetomaternal outcomes.
UNASSIGNED: In 50 women enrolled, prenatal ultrasound staging was performed and PAS score 0, 1, 2 and 3 was assigned. Cesarean hysterectomy was required in all 21(42%) women with PAS score > 0 (PAS 1, 2, 3). Intraoperative, focal and complete invasion was seen in 4% and 38%, respectively, and FIGO grade 1, 2, 3, 4, 5 and 6 was observed in 46%, 16%, 30%, 0%, 6% and 2%, respectively. On histopathology, 14.28% (3/21) with PAS > 0 did not have any invasion, while 85.71% (18/21) had invasion, i.e., accreta, increta and percreta in 57.14%, 19.05% and 9.52%, respectively. Considering histopathology as gold standard, the overall sensitivity, specificity, PPV, NPV and diagnostic accuracy of PAS score were 100%, 90.62%, 85.71%, 100% and 94%, respectively.
UNASSIGNED: Prenatal ultrasound staging system is a simple and feasible screening modality. Hence, it should be used in all high-risk women with placenta previa and scarred uterus for definitive prenatal diagnosis of PAS.