Feto-maternal outcomes of patients with placenta previa and accuracy of diagnosis of placenta accreta syndrome at Chris Hani Baragwanath Academic Hospital
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Abstract
Background. The incidence of placenta praevia (PP) is 0.3 - 0.5% of pregnancies and it is a major risk factor for placenta accreta syndrome (PAS). PP and PAS cause immense feto-maternal morbidity and mortality and, as a result, place a huge burden on healthcare resources. Hence, accurate diagnosis prenatally of PP and associated PAS is essential as this allows adequate preparation for potential complications.
Objective. To ascertain the accuracy of prenatal diagnosis of PP and PAS, and the feto-maternal effects of these conditions in women diagnosed at Chris Hani Baragwanath Academic Hospital (CHBAH)
Methods. This was a retrospective, descriptive study that reviewed the medical files of 55 women diagnosed with PP at CHBAH in 2018.
Results. Complete data was obtained for 28 women. The incidence of PP was 0.3%. The mean age, gravity and parity of women with PP were 31.65 (6.0) years, 3.0 (1.3) and 1.7 (1.3), respectively. The mean birthweight was 2 244 (730) g. Eighteen (56.2%) of newborns had birth weight <2 500g. The incidence of adverse outcomes was increased in patients with suspected PAS on prenatal ultrasound compared with patients showing no prenatal ultrasound evidence of PAS. Ultrasound had a positive predictive value of 50% while MRI correctly identified PAS in 33.3% of patients.
Conclusion. PP and PAS increase the likelihood of maternal and neonatal morbidities. Ultrasound is a useful tool in evaluating placenta implantation and can assist in anticipating adverse feto-maternal outcomes in PP and PAS. MRI has limited clinical value in this setting Keywords. Placenta praevia (PP), Placenta accreta syndrome (PAS), Chris Hani Baragwanath Academic Hospital (CHBAH), Magnetic Resonance Imaging (MRI) currently, and should not be done routinely.
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References
1. Harper LM, Odibo AO, MacOnes GA, Crane JP, Cahill AG. Effects of placenta previa on fetal growth. Am J Obstst Gynecol 2010;203(4):330-330. https://doi.org/10.1016/j.ajog.2010.05.014
2. Nageotte MP. Always be vigilant for placenta accreta. Am J Obstet Gynecol 2019;211(2):87-88.
https://doi.org/10.1016/j.ajog.2014.04.037
3. Bowman SZ, Eller GA, Bardsley RT, Greene T, Varner WM, Silver MR. Risk factors for placenta accreta: A large prospective cohort. Am J Perinatol 2014;31(9):799-804. https://doi. org/10.1055/s-0033-1361833
4. Baughman WC, Corteville JE, Shah RR. Placenta acreta: Spectrum of US and MRI imaging findings. Radiographics 2008;28(7):1905-1916. https://doi.org/10.1148/rg.287085060
5. Hoque ME. Advanced maternal age and outcomes of pregnancy: A retrospective study from South Africa. Biomed Res 2012;23(2):281-285. http://www.biomedres.org/journal/pdf%5Cn (accessed 9 June 2019).
6. Zhang MBJ, Savitz DA. Maternal age and placenta previa: A population-based, case control study. Am J Obstet Gynecol 1993;168(2):641-645. https://doi.org/10.1016/0002-9378(93)90511-G
7. Chelmow D, Andrew DE, Baker ER. Maternal cigarette smoking and placenta previa. Obstst Gynecol 1996;87(5):1-4. https://doi.org/10.1016/00297844(95)00471-8
8. Sheiner E, Shoham-Vardi I, Hallak M, Hershkowitz R, Katz M, Mazar M. Placenta previa: Obstetrics risk factors and pregnancy outcomes. J Matern fetal Med 2009;102001(6):414-419. https://doi.org/10.1080/jmf.10.6.414.419
9. Jauniaux E, Chantraine F, Silver RM. FIGO consensus guidelines on placenta accreta spectrum disorders: Epidemiology. Int J Gynecol Obstet 2018;140(3):265-273. https://doi.org/10.1002/ ijgo.12407
10. Faiz AS, Ananth CV. Etiology and risk factors for placenta previa: An overview and meta-analysis of observational studies. J Matern Fetal Neonatal Med 2003;13:175-190. https://doi.org/10.1080/ jmf.13.3.175.190
11. Arditi B, Purisch S, Friedman A, Gyamfi-Bannerman C. Maternal morbidity and BMI in placenta previa. Obstet Gynecol 2019;133(1):24s. https://doi.org/10.1097/01OG.0000559400.01667.99
12. Kumari AS. Pregnancy outcome in women with morbid obesity. Int J Gynecol Obstet
2001;73(2):101-107. https://doi.org/10.1016/s0020-7292(00)0039-X
13. Cahill AG, Beigi R, Silver RM, Heine RP, Wax JR. Placenta accreta spectrum. Am J Obstet Gynecol
2019;219(6):2-16. https://doi.org/10.1016/j.ajog.2018.09.042
14. Wu S, Kocherginsky M, Hibbard JU. Abnormal placentation: Twenty-year analysis. Am J Obstet
Gynecol 2005:192(5):1458-1461. https://doi.org/10.1016/j.ajog.2004.12.074
15. Usta IM, Hobeika EM, Abu Musa AA, Gabriel GE, Nassar AH. Placenta previa-accreta. Risk factors and complications. Am J Obstet Gynecol 2005;193(3):1045-1049. https://doi.org/10.1016/j.
ajog.2005.06.037
16. Kalimba EM, Ballot DE. Survival of extremely low-birth weight infants. South African. J Child Health 2013;7(1):6-13. https://doi.org/107196/sajch.488
17. Rahim NSA, Whitby Eh. The MRI features of placental adhesion disorder and their diagnostic significance: Systemic review. Clin Radiol 2015;70(9):917-925. https://doi.org/10.1016/j. crad.2015.04.010
18. Ebrahim MA, Zaiton F, Elkamash TH. Clinical and ultrasound assessment in patients with placenta previa to predict the severity of intrapartum hemorrhage. Egypt J Radio Nuc Med 2013;44(3):657- 663. https://doi.org/10.1016/j.ejrnm.2013.05.005
19. EInerson BD, Rodriguez CE, Kenedy AM, Woodward PJ, Donnelly MA, Silver RM. Magnetic resonance imaging is often misleading when used as an adjunct to ultrasound in the management of placenta accreta spectrum disorders. Am J Obstet Gynecol 2018;218(6):618-618. https://doi. org/10.1016/j.ajog.2018.03.013
20. Dweyer BK, Belogolovkin V, Tran l, et al. Prenatal diagnosis of placenta accreta: Sonography or magnetic resonance imaging? J Ultrasound Med 2008:27(9):1275-1281. https://doi.org/10.7863/ jum.2008.27.9.1275