Top

Archives of Gynecology and Obstetrics

Published in:

01-03-2020 | Ureteral Injury | Images in Obstetrics and Gynecology

Placenta percreta evaluated by MRI: correlation with maternal morbidity

Authors: Xin Chen, Ruiqin Shan, Qingxu Song, Xinhong Wei, Wen Liu, Guangbin Wang

Published in: Archives of Gynecology and Obstetrics | Issue 3/2020

Abstract

Purpose

The purpose of this study was to evaluate the capability of MRI in depicting the topography of placenta percreta (PP) and to further explore the correlation between invasion topography and maternal outcomes.

Methods

55 patients with histologically or surgically confirmed PP were included in this retrospective study. Two senior radiologists evaluated the topography of PP based on MR images: the invasion topography was depicted as S1, S2, parametrial, bladder, and cervical invasion. The correlation between invasion topography and maternal outcomes was analyzed using Chi-square statistic.

Results

MRI showed high sensitivity and specificity in delineating the invasion topography of PP (ranging from 87.5 to 100%). MRI had 100% specificity for predicting the parametrial, bladder, and cervical invasion. The rate of cesarean hysterectomy, ureteral injuries and ICU administration, and the amount of blood transfusions in PP with S2 invasion were higher than S1 invasion (P < 0.05). In addition, all patients with bladder invasion (8/8) received partial bladder resection by urologists. All the patients with S2 parametrial invasion (12/12) or cervical invasion (9/9) underwent cesarean hysterectomy.

Conclusion

MRI was capable in predicting the invasion topography of PP patients. Moreover, PP patients with S2, parametrial, bladder or cervical invasion had more severe maternal morbidity.

Publications Committee, SfM-FM and MA Belfort (2010) Placenta accreta. Am J Obstet Gynecol 203:430–439. https://doi.org/10.1016/j.ajog.2010.09.013 CrossRef

Clausen C, Lonn L, Langhoff-Roos J (2014) Management of placenta percreta: a review of published cases. Acta Obstet Gynecol Scand 93:138–143. https://doi.org/10.1111/aogs.12295 CrossRefPubMed

Mc KR, D'Errico E (1951) Placenta accreta: clinical manifestations and conservative management. N Engl J Med. 245:159–165. https://doi.org/10.1056/NEJM195108022450501 CrossRef

Dew L, Harris S, Yost N, Magee K, dePrisco G (2015) Second trimester placenta percreta presenting as acute abdomen. Proc (Bayl Univ Med Cent). 28:38–40CrossRef

Shamshirsaz AA, Fox KA, Salmanian B, Diaz-Arrastia CR, Lee W, Baker BW, Ballas J, Chen Q, Van Veen TR, Javadian P, Sangi-Haghpeykar H, Zacharias N, Welty S, Cassady CI, Moaddab A, Popek EJ, Hui SK, Teruya J, Bandi V, Coburn M, Cunningham T, Martin SR, Belfort MA (2015) Maternal morbidity in patients with morbidly adherent placenta treated with and without a standardized multidisciplinary approach. Am J Obstet Gynecol. 212(218):e1–9. https://doi.org/10.1016/j.ajog.2014.08.019 CrossRef

Eller AG, Bennett MA, Sharshiner M, Masheter C, Soisson AP, Dodson M, Silver RM (2011) Maternal morbidity in cases of placenta accreta managed by a multidisciplinary care team compared with standard obstetric care. Obstet Gynecol. 117:331–337CrossRef

Warshak CR, Ramos GA, Eskander R, Benirschke K, Saenz CC, Kelly TF, Moore TR, Resnik R (2010) Effect of predelivery diagnosis in 99 consecutive cases of placenta accreta. Obstet Gynecol. 115:65–69. https://doi.org/10.1097/AOG.0b013e3181c4f12a CrossRefPubMed

Fitzpatrick, KE, S Sellers, P Spark, JJ Kurinczuk, P Brocklehurst, M Knight (2014) The management and outcomes of placenta accreta, increta, and percreta in the UK: a population-based descriptive study. BJOG 121:62–70. https://doi.org/10.1111/1471-0528.12405(discussion 70–1) CrossRef

Tikkanen M, Paavonen J, Loukovaara M, Stefanovic V (2011) Antenatal diagnosis of placenta accreta leads to reduced blood loss. Acta Obstet Gynecol Scand. 90:1140–1146. https://doi.org/10.1111/j.1600-0412.2011.01147.x CrossRefPubMed

10.

D'Antonio F, Palacios-Jaraquemada J, Timor-Trisch I, Cali G (2018) Placenta accreta spectrum disorders: prenatal diagnosis still lacks clinical correlation. Acta Obstet Gynecol Scand. 97:773–775. https://doi.org/10.1111/aogs.13374 CrossRefPubMed

11.

Matsuzaki S, Yoshino K, Endo M, Kakigano A, Takiuchi T, Kimura T (2018) Conservative management of placenta percreta. Int J Gynaecol Obstet. 140:299–306. https://doi.org/10.1002/ijgo.12411 CrossRefPubMed

12.

Karaman E, Kolusari A, Cetin O, Cim N, Alkis I, Yildizhan R, Sahin HG, Gul A (2017) Local resection may be a strong alternative to cesarean hysterectomy in conservative surgical management of placenta percreta: experiences from a tertiary hospital. J Matern Fetal Neonatal Med. 30:947–952. https://doi.org/10.1080/14767058.2016.1192119 CrossRefPubMed

13.

Palacios Jaraquemada JM, Bruno CH (2005) Magnetic resonance imaging in 300 cases of placenta accreta: surgical correlation of new findings. Acta Obstet Gynecol Scand. 84:716–724. https://doi.org/10.1111/j.0001-6349.2005.00832.x CrossRefPubMed

14.

Masselli G, Brunelli R, Casciani E, Polettini E, Piccioni MG, Anceschi M, Gualdi G (2008) Magnetic resonance imaging in the evaluation of placental adhesive disorders: correlation with color Doppler ultrasound. Eur Radiol. 18:1292–1299. https://doi.org/10.1007/s00330-008-0862-8 CrossRefPubMed

15.

Chen X, Shan R, Zhao L, Song Q, Zuo C, Zhang X, Wang S, Shi H, Gao F, Qian T, Wang G, Limperopoulos C (2018) Invasive placenta previa: Placental bulge with distorted uterine outline and uterine serosal hypervascularity at 1.5T MRI - useful features for differentiating placenta percreta from placenta accreta. Eur Radiol. 28:708–717. https://doi.org/10.1007/s00330-017-4980-z CrossRefPubMed

16.

Palacios-Jaraquemada JM, Bruno CH, Martin E (2013) MRI in the diagnosis and surgical management of abnormal placentation. Acta Obstet Gynecol Scand. 92:392–397. https://doi.org/10.1111/j.1600-0412.2012.01527.x CrossRefPubMed

17.

Bourgioti C, Zafeiropoulou K, Fotopoulos S, Nikolaidou ME, Antoniou A, Tzavara C, Moulopoulos LA (2018) MRI features predictive of invasive placenta with extrauterine spread in high-risk gravid patients: a prospective evaluation. AJR Am J Roentgenol. 211:701–711. https://doi.org/10.2214/AJR.17.19303 CrossRefPubMed

18.

Lopes ES, Feitosa FEL, Brazil AV, de Castro JDV, da Costa JIF, Araujo Junior E, Peixoto AB, Carvalho FHC (2018) Assessment of sensitivity and specificity of ultrasound and magnetic resonance imaging in the diagnosis of placenta accreta. Rev Bras Ginecol Obstet. https://doi.org/10.1055/s-0038-1675803 CrossRefPubMed

19.

Norris BL, Everaerts W, Posma E, Murphy DG, Umstad MP, Costello AJ, Wrede CD, Kearsley J (2016) The urologist's role in multidisciplinary management of placenta percreta. BJU Int. 117:961–965. https://doi.org/10.1111/bju.13332 CrossRefPubMed

20.

Ng MK, Jack GS, Bolton DM, Lawrentschuk N (2009) Placenta percreta with urinary tract involvement: the case for a multidisciplinary approach. Urology. 74:778–782. https://doi.org/10.1016/j.urology.2009.01.071 CrossRefPubMed

21.

Alanwar A, Al-Sayed HM, Ibrahim AM, Elkotb AM, Abdelshafy A, Abdelhadi R, Abbas AM, Abdelmenam HS, Fares T, Nossair W, Abdallah AA, Sabaa H, Nawara M (2017) Urinary tract injuries during cesarean section in patients with morbid placental adherence: retrospective cohort study. J Matern Fetal Neonatal Med. https://doi.org/10.1080/14767058.2017.1408069 CrossRefPubMed

22.

Borekci B, Ingec M, Kumtepe Y, Gundogdu C, Kadanali S (2008) Difficulty of the surgical management of a case with placenta percreta invading towards parametrium. J Obstet Gynaecol Res. 34:402–404. https://doi.org/10.1111/j.1447-0756.2008.00780.x CrossRefPubMed

23.

Hoffman MS, Karlnoski RA, Mangar D, Whiteman VE, Zweibel BR, Lockhart JL, Camporesi EM (2010) Morbidity associated with nonemergent hysterectomy for placenta accreta. Am J Obstet Gynecol. 202(628):e1–5. https://doi.org/10.1016/j.ajog.2010.03.021 CrossRef

24.

Liu W, Chen X, Sun C, Wei X, Wang G, Shan R (2018) Morphological evaluation of cervix using MRI at 32 to 36 weeks of gestation: findings for predicting invasive placenta previa. Medicine (Baltimore). 97:e13375. https://doi.org/10.1097/MD.0000000000013375 CrossRefPubMedPubMedCentral

25.

Leyendecker JR, Gorengaut V, Brown JJ (2004) MR imaging of maternal diseases of the abdomen and pelvis during pregnancy and the immediate postpartum period. Radiographics. 24:1301–1316. https://doi.org/10.1148/rg.245045036 CrossRefPubMed

26.

Palacios Jaraquemada JM, Garcia Monaco R, Barbosa NE, Ferle L, Iriarte H, Conesa HA (2007) Lower uterine blood supply: extrauterine anastomotic system and its application in surgical devascularization techniques. Acta Obstet Gynecol Scand. 86:228–234. https://doi.org/10.1080/00016340601089875 CrossRefPubMed

27.

Washecka R, Behling A (2002) Urologic complications of placenta percreta invading the urinary bladder: a case report and review of the literature. Hawaii Med J. 61:66–69PubMed

Title: Placenta percreta evaluated by MRI: correlation with maternal morbidity
Authors: Xin Chen
Ruiqin Shan
Qingxu Song
Xinhong Wei
Wen Liu
Guangbin Wang
Publication date: 01-03-2020
Publisher: Springer Berlin Heidelberg
Keywords: Ureteral Injury
Hysterectomy
Published in: Archives of Gynecology and Obstetrics / Issue 3/2020
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-019-05420-5

At a glance: The STEP trials

Springer Medicine

Placenta percreta evaluated by MRI: correlation with maternal morbidity

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 3/2020

The impact of p16ink4a positivity in invasive vulvar cancer on disease-free and disease-specific survival, a retrospective study

Effect of music on labor and delivery in nulliparous singleton pregnancies: a randomized clinical trial

Intrahepatic cholestasis of pregnancy as a risk factor for preeclampsia

Sentinel lymph node mapping with fluorescent and radioactive tracers in vulvar cancer patients

Prevalence, risk factors and pregnancy outcomes of women with vascular brain lesions in pregnancy

Is tubal endometriosis an asymmetric disease? A 17-year retrospective study