From the Department of Obstetrics and Gynecology, College of Medicine, King Khalid University, Abha, Saudi Arabia.
From the Department of Community and Family Medicine, King Khalid University, Abha, Saudi Arabia.
Ann Saudi Med. 2023 Jul-Aug;43(4):219-217. doi: 10.5144/0256-4947.2023.219. Epub 2023 Aug 3.
Antenatal assessment of maternal risk factors and imaging evaluation can help in diagnosis and treatment of placenta accreta spectrum (PAS) in major placenta previa (PP). Recent evidence suggests that magnetic resonance imaging (MRI) could complement ultrasonography (US) in the PAS diagnosis.
Evaluate the incidence, risk factors, and maternal morbidity related to the MRI diagnosis of PAS in major PP.
A 10-year retrospective cohort study.
Tertiary care hospital.
We report on patients with major PP who had cesarean delivery in Abha Maternity and Children's Hospital (AMCH) over a 10-year period (2012-2021). They were evaluated with ultrasonography (US) and color Doppler for evidence of PAS. Antenatal MRI was ordered either to confirm the diagnosis (if equivocal US) or to assess the depth of invasion/extra-uterine extension (if definitive US).
Risk factors for PAS in major PP and maternal complications.
299 patients RESULTS: Among 299 patients, MRI confirmed the PAS diagnosis in 91/299 (30.5%) patients. The independent risk factors for MRI diagnosis of PAS in major PP included only repeated cesarean sections and advanced maternal age. The commonest maternal morbidity in major PP with PAS was significantly excessive intraoperative bleeding.
MRI may be a valuable adjunct in the evaluation of PAS in major PP; as a complement, but not substitute US. MRI may be suitable in major PP/PAS patients who are older and have repeated cesarean deliveries with equivocal results or deep/extra-uterine extension on US.
Single center, small sample size, lack of complete histopathological diagnosis.
None.
产前评估母体危险因素和影像学评估有助于诊断和治疗主要前置胎盘（PP）中的胎盘植入谱系（PAS）。最近的证据表明，磁共振成像（MRI）可以补充超声（US）在 PAS 诊断中的作用。
评估主要前置胎盘（PP）中 PAS 的 MRI 诊断的发生率、危险因素和与母体发病率相关的因素。
一项 10 年回顾性队列研究。
三级保健医院。
我们报告了在阿巴母婴医院（AMCH）进行剖宫产的 10 年期间（2012-2021 年）患有主要 PP 的患者。对他们进行超声（US）和彩色多普勒检查，以评估 PAS 的证据。如果 US 结果不确定，则进行产前 MRI 检查以确认诊断；如果 US 结果明确，则进行评估以评估侵犯/子宫外延伸的深度。
主要 PP 中 PAS 的危险因素和母体并发症。
299 例患者。
在 299 例患者中，MRI 确认 PAS 诊断 91/299（30.5%）例。MRI 诊断主要 PP 中 PAS 的独立危险因素仅包括重复剖宫产和高龄产妇。在 PAS 合并主要 PP 中最常见的母体并发症是术中过度出血。
MRI 可能是评估主要 PP 中 PAS 的一种有价值的辅助手段；作为一种补充手段，但不能替代 US。MRI 可能适用于年龄较大且有重复剖宫产史、US 结果不确定或深度/子宫外延伸的主要 PP/PAS 患者。
单中心、样本量小、缺乏完整的组织病理学诊断。
无。
