Novel markers of Doppler ultrasonography in the placenta accreta spectrum to predict complications
Doppler ultrasonography
PAS
PSV
hemorrhage
hysterectomy
placenta accreta spectrum
Journal
Journal of the Turkish German Gynecological Association
ISSN: 1309-0399
Titre abrégé: J Turk Ger Gynecol Assoc
Pays: Turkey
ID NLM: 101272522
Informations de publication
Date de publication:
06 12 2023
06 12 2023
Historique:
medline:
26
10
2023
pubmed:
26
10
2023
entrez:
26
10
2023
Statut:
ppublish
Résumé
Ultrasonography (US) is an acceptable tool to diagnose the placenta accreta spectrum (PAS) among pregnant women. However, the lack of a robust criteria for diagnosis and predicting the severity of the consequences facing pregnant women requires identification of novel biomarkers. This prospective, cross-sectional study was performed on pregnant women with a probable diagnosis of PAS. Their demographic information, medical and surgical history, blood loss severity (severe ≥2500 mL) following hysterectomy, and the histopathology after the surgery were collected. In addition, the Doppler imaging of both uterine arteries, including the pulsatility index, resistance index, peak systolic velocity (PSV), the PSV of the posterior part of the bladder, cervix, the largest lacuna, and the posterior lacuna of the bladder were calculated by Doppler US. Data were analyzed to investigate the relationship between Doppler markers and the severity of PAS in terms of bleeding, hysterectomy, and histopathology. Fifty-one women were enrolled with a mean age of 35.4±4.11 years and 17 (33.3%) had severe bleeding. There were significant differences between median (range) bladder PSV [57 (34-90) vs. 33 (20-64); p<0.001], cervix PSV [26 (0-63) vs. 18 (0-76); p=0.04] and left uterine artery [89 (81-135) vs. 68 (61-113); p=0.045] for women with and without severe bleeding, respectively. Thirty-four (66.66%) had hysterectomy. Comparison of bladder PSV, cervix PSV, and left uterine PSV for women with and without hysterectomy were 46 (20-90) vs. 39.5 (33-46) (p=0.005), 20 (0-76) vs. 20 (14-26) (p=0.013) and 68 (61-135) vs. 82 (63-101) (p=0.003), respectively. Bladder PSV, cervix PSV, and uterine PSV were significantly higher in pregnant women with PAS, and they may be useful diagnostic and prognostic markers.
Identifiants
pubmed: 37882615
doi: 10.4274/jtgga.galenos.2023.2023-2-10
pmc: PMC10702256
doi:
Types de publication
Journal Article
Langues
eng
Pagination
228-234Informations de copyright
©Copyright 2023 by the Turkish-German Gynecological Education and Research Foundation. Journal of the Turkish-German Gynecological Association is published by Galenos Publishing House.
Déclaration de conflit d'intérêts
Conflict of Interest: No conflict of interest is declared by the authors.
Références
J Matern Fetal Neonatal Med. 2020 Jun;33(11):1824-1830
pubmed: 30269669
Cochrane Database Syst Rev. 2015 Apr 15;(4):CD001450
pubmed: 25874722
Radiology. 1997 Dec;205(3):773-6
pubmed: 9393534
Am J Obstet Gynecol. 2021 Nov;225(5):534.e1-534.e38
pubmed: 33894149
Arch Gynecol Obstet. 2020 Nov;302(5):1143-1150
pubmed: 32740869
Int J Gynaecol Obstet. 2019 Jul;146(1):20-24
pubmed: 31173360
J Obstet Gynaecol Res. 2022 May;48(5):1149-1156
pubmed: 35233884
J Ultrasound Med. 2021 Dec;40(12):2735-2743
pubmed: 33724510
Am J Obstet Gynecol. 2021 Jan;224(1):B2-B14
pubmed: 33386103
Ultrasound Obstet Gynecol. 1995 Mar;5(3):198-201
pubmed: 7788495
Obstet Gynecol Int. 2022 Jun 24;2022:2830066
pubmed: 35784378
Obstet Gynecol. 2015 Sep;126(3):645-653
pubmed: 26214694
Ultrasound Obstet Gynecol. 2016 Mar;47(3):290-301
pubmed: 26195324
Am J Obstet Gynecol. 2012 Jul;207(1):14-29
pubmed: 22516620
Womens Health (Lond). 2019 Jan-Dec;15:1745506519878081
pubmed: 31578123
Arch Gynecol Obstet. 2019 Mar;299(3):695-702
pubmed: 30607590
BMC Pregnancy Childbirth. 2019 Aug 27;19(1):313
pubmed: 31455286
Medicine (Baltimore). 2018 Aug;97(35):e12111
pubmed: 30170439