Effect of placenta location detected by ultrasound on the severity of placenta accreta spectrum in patients with placenta previa and placenta accreta spectrum.
Anterior placenta
Non-central placenta
Placenta accreta spectrum
Placenta previa
Placental location
Journal
BMC pregnancy and childbirth
ISSN: 1471-2393
Titre abrégé: BMC Pregnancy Childbirth
Pays: England
ID NLM: 100967799
Informations de publication
Date de publication:
01 Jun 2023
01 Jun 2023
Historique:
received:
24
08
2022
accepted:
25
05
2023
medline:
5
6
2023
pubmed:
2
6
2023
entrez:
1
6
2023
Statut:
epublish
Résumé
To evaluate the effect of placental location on the severity of placenta accreta spectrum (PAS). We analyzed 390 patients with placenta previa combined with placenta accreta spectrum who underwent cesarean section between January 1, 2014 and December 30, 2020 in the electronic case database of the Second Hospital of Hebei Medical University. According to the position of the placenta, 390 placentas were divided into the posterior group (n = 89), the anterior group (n = 60) and the non-central group (n = 241). The history of cesarean delivery rates in the anterior group (91.67%) and the non-central group (85.71%) were statistically different from the posterior group (63.74%)(P < 0.001). Univariate logistic regression results showed that employment, urban living, gestational age, complete placenta previa, fetal presentation shoulder, gravidity, cesarean section and vaginal delivery were all predictors for the severity of placenta accreta (P < 0.05). The anterior group (P = 0.001, OR = 4.13, 95%CI: 1.84-9.24) and the non-central group (P = 0.001, OR = 2.90, 95%CI: 1.55-5.45) had a higher incidence of invasive accreta placentation than the posterior group, and were independent risk factors for invasive accreta placentation. Compared with posterior placenta, anterior and non-central placenta are independent risk factors for invasive PAS in patients with placenta previa, during which we should be more cautious in treatment.
Sections du résumé
BACKGROUND
BACKGROUND
To evaluate the effect of placental location on the severity of placenta accreta spectrum (PAS).
METHODS
METHODS
We analyzed 390 patients with placenta previa combined with placenta accreta spectrum who underwent cesarean section between January 1, 2014 and December 30, 2020 in the electronic case database of the Second Hospital of Hebei Medical University. According to the position of the placenta, 390 placentas were divided into the posterior group (n = 89), the anterior group (n = 60) and the non-central group (n = 241).
RESULTS
RESULTS
The history of cesarean delivery rates in the anterior group (91.67%) and the non-central group (85.71%) were statistically different from the posterior group (63.74%)(P < 0.001). Univariate logistic regression results showed that employment, urban living, gestational age, complete placenta previa, fetal presentation shoulder, gravidity, cesarean section and vaginal delivery were all predictors for the severity of placenta accreta (P < 0.05). The anterior group (P = 0.001, OR = 4.13, 95%CI: 1.84-9.24) and the non-central group (P = 0.001, OR = 2.90, 95%CI: 1.55-5.45) had a higher incidence of invasive accreta placentation than the posterior group, and were independent risk factors for invasive accreta placentation.
CONCLUSION
CONCLUSIONS
Compared with posterior placenta, anterior and non-central placenta are independent risk factors for invasive PAS in patients with placenta previa, during which we should be more cautious in treatment.
Identifiants
pubmed: 37264325
doi: 10.1186/s12884-023-05736-w
pii: 10.1186/s12884-023-05736-w
pmc: PMC10236818
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
406Informations de copyright
© 2023. The Author(s).
Références
Am J Obstet Gynecol. 2014 Aug;211(2):87-8
pubmed: 25077458
Am J Obstet Gynecol. 2019 Oct;221(4):357.e1-357.e5
pubmed: 31344349
Am J Obstet Gynecol. 2015 May;212(5):561-8
pubmed: 25460838
Medicine (Baltimore). 2017 Apr;96(16):e6636
pubmed: 28422862
BMC Pregnancy Childbirth. 2019 Nov 27;19(1):447
pubmed: 31775687
N Engl J Med. 2018 Apr 19;378(16):1529-1536
pubmed: 29669225
N Am J Med Sci. 2011 Aug;3(8):358-61
pubmed: 22171242
Eur J Obstet Gynecol Reprod Biol. 2021 Apr;259:81-89
pubmed: 33601317
Clin Obstet Gynecol. 2018 Dec;61(4):733-742
pubmed: 30204619
Int J Gynaecol Obstet. 2019 Jul;146(1):20-24
pubmed: 31173360
Ultrasound Obstet Gynecol. 2020 Apr;55(4):450-459
pubmed: 31788885
Am J Perinatol. 2014 Oct;31(9):799-804
pubmed: 24338130
Am J Obstet Gynecol. 2018 Aug;219(2):193.e1-193.e9
pubmed: 29733839
Am J Obstet Gynecol. 1988 Dec;159(6):1504-8
pubmed: 3061298
PLoS One. 2018 Jul 17;13(7):e0200252
pubmed: 30016336
Ultrasound Med Biol. 2023 Feb;49(2):512-519
pubmed: 36347659
Obstet Gynecol. 2012 Jul;120(1):207-11
pubmed: 22914422
Mod Pathol. 2020 Dec;33(12):2382-2396
pubmed: 32415266
J Matern Fetal Neonatal Med. 2012 Oct;25(10):2042-5
pubmed: 22463851
Obstet Gynecol Clin North Am. 2019 Dec;46(4):797-811
pubmed: 31677755
Placenta. 2015 Apr;36(4):463-6
pubmed: 25573094
Int J Gynaecol Obstet. 2018 Mar;140(3):265-273
pubmed: 29405321
BJOG. 2014 Jan;121(1):62-70; discussion 70-1
pubmed: 23924326
Acta Obstet Gynecol Scand. 2019 Aug;98(8):988-996
pubmed: 30767210
Am J Obstet Gynecol. 2022 May;226(5):720.e1-720.e6
pubmed: 35139335
Am J Obstet Gynecol. 2013 Mar;208(3):219.e1-7
pubmed: 23313722
Int J Gynaecol Obstet. 2023 Feb 2;:
pubmed: 36728539