Division of Obstetrics and Gynecology, ASST Spedali Civili.
Department of Clinical and Experimental Sciences, University of Brescia, Brescia.
Curr Opin Obstet Gynecol. 2022 Oct 1;34(5):287-291. doi: 10.1097/GCO.0000000000000811. Epub 2022 Jul 11.
Systematic screening and diagnosis of placenta accreta spectrum disorder (PAS) either by ultrasound or magnetic resonance imaging (MRI) would allow referral of high-risk women to specialized multidisciplinary teams. We aimed to report recent findings regarding the diagnostic accuracy of ultrasound and magnetic resonance imaging in the diagnosis of PAS.
Recent evidence from the literature shows that both ultrasound and MRI are good tests to identify PAS in high-risk populations. Ultrasound can also be used safely to guide management decisions, concentrating greater resources in patients with the higher risk of clinically significant PAS requiring complex peripartum management. Moreover, there are increasing data showing that routine contingent screening for PAS disorders based on the finding of a placenta implanted low in the uterine cavity and previous uterine surgery is effective in a public healthcare setting. A contingent screening strategy for PAS is feasible if placental location is routinely assessed during routine scans, and may even start from the first trimester of pregnancy.
Ultrasound is an effective tool to screen pregnancies at high risk of PAS. In such pregnancies, ultrasound and MRI are effective imaging modalities for guiding management.
通过超声或磁共振成像（MRI）对胎盘植入疾病谱（PAS）进行系统筛查和诊断，可将高危产妇转介至多学科专业团队。本研究旨在报告超声和 MRI 在 PAS 诊断中的诊断准确性的最新研究结果。
来自文献的最新证据表明，超声和 MRI 都是用于识别高危人群 PAS 的良好检测方法。超声还可安全地用于指导管理决策，将更多资源集中用于那些有更高风险发生临床显著 PAS 并需要复杂围产期管理的患者。此外，越来越多的数据表明，在公共医疗保健环境中，基于胎盘植入子宫腔下部和既往子宫手术的发现对 PAS 疾病进行常规的有条件筛查是有效的。如果在常规扫描中常规评估胎盘位置，则 PAS 的有条件筛查策略是可行的，甚至可以从妊娠早期开始。
超声是筛查 PAS 高危妊娠的有效工具。在这些妊娠中，超声和 MRI 是指导管理的有效影像学方法。
