Youwen Mei, Dan Luo, Sumei Wei, Liming Wang, Xiaoyan Liao, Huaibo Jing, Yonghong Lin, Hu Zhao
OBJECTIVE: The objective of the study was to compare outcomes of women with placenta accreta spectrum(PAS) who underwent emergency cesarean hysterectomy with and without prophylactic intravascular balloon catheters. Methods Sixty-three cases who had emergency hysterectomy related to PAS disorders were retrospectively analyzed. Subjects with prophylactic intravascular balloon catheter placement plus hysterectomy were compared with those who had hysterectomy alone. The cases were divided into three groups: infrarenal aortic artery balloon occlusion (IAABC) group (who had IAABC plus hysterectomy, n  = 31), internal iliac artery balloon occlusion (IIABOC) group (who had IIABOC plus hysterectomy, n  = 17), and hysterectomy alone group (control group n  = 15)...
September 20, 2020: Journal of Maternal-fetal & Neonatal Medicine
Tian Yang, Na Li, Rui Hou, Chong Qiao, Caixia Liu
Background: Placenta accreta spectrum (PAS) is a major cause of maternal morbidity and mortality in modern obstetrics, however, few studies have explored the underlying molecular mechanisms and biomarkers. In this study, we aimed to elucidate the regulatory RNA network contributing to PAS, comprising long non-coding (lnc), micro (mi), and messenger (m) RNAs, and identify biomarkers for the prediction of intraoperative blood volume loss. Methods: Using RNA sequencing, we compared mRNA, lncRNA, and miRNA expression profiles between five PAS and five normal placental tissues...
August 2020: Annals of Translational Medicine
Helena C Bartels, Karen M Mulligan, Joan G Lalor, Mary F Higgins, Donal J Brennan
BACKGROUND: The incidence of Placenta Accreta Spectrum (PAS) is increasing. This study explores women's personal experience of a pregnancy, birth and early postpartum period complicated by PAS. METHODS: A qualitative study involving seven women (age range: 33-44 years) following a pregnancy in the previous two years complicated by PAS was conducted. Using an Interpretative Phenomenological Analysis approach data were collected and analysed in 2019 and 2020 through face-to-face interviews...
September 13, 2020: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Tayyebe Khamoushi, Moslem Ahmadi, Mohammad Ali-Hassanzadeh, Maryam Zare, Fateme Hesampour, Behrouz Gharesi-Fard, Sedigheh Amooee
OBJECTIVE: Placenta accreta is a pregnancy-related disorder with extreme trophoblast invasion and the adherence of the placenta to the uterine wall. This study aimed to investigate the serum level of transforming growth factor-beta 1 (TGF-β1) and interleukin (IL)-35 in patients with placenta accreta. METHODS: Thirty-one women with placenta accreta and 57 healthy pregnant women were enrolled. The serum levels of TGF-β1 and IL-35 were measured using the enzyme-linked immunosorbent assay method...
September 14, 2020: Laboratory Medicine
Heather J Baldwin, Tanya A Nippita, Siranda Torvaldsen, Ibinabo Ibiebele, Jane B Ford, Jillian A Patterson
OBJECTIVE: To investigate subsequent birth rates, maternal and neonatal outcomes for women with a history of placenta accreta spectrum (placenta accreta, increta, and percreta). METHODS: A population-based record linkage study of women who had a first, second, or third birth in New South Wales from 2003 to 2016 was conducted. Data were obtained from birth and hospital records and death registrations. Women with a history of placenta accreta spectrum were matched to women without, on propensity score and parity, to compare outcomes with women who had similar risk profiles...
September 10, 2020: Obstetrics and Gynecology
Hiroaki Soyama, Morikazu Miyamoto, Hiroki Ishibashi, Hideki Iwahashi, Hiroko Matsuura, Soichiro Kakimoto, Rie Suzuki, Takahiro Sakamoto, Taira Hada, Masashi Takano
AIM: To investigate the differences in epithelial-mesenchymal transition (EMT)- and matrix metalloproteinases (MMP)-related factors among placenta previa with and without placenta accreta spectrum (PAS) (n = 69), and normal placenta (n = 51). METHODS: The women diagnosed with placenta previa with or without PAS, and normal placentas, who delivered at our institution between 2006 and 2016, were enrolled. The difference of EMT-related factors' expression by immunochemical analysis in chorionic villi and decidual cells between the normal placenta and placenta previa with or without PAS were evaluated...
September 13, 2020: Journal of Obstetrics and Gynaecology Research
Loïc Sentilhes, Gilles Kayem, Aurélien Mattuizzi
Intentional retention of the placenta (IRP), or 'conservative' treatment or management, entails opening the uterus, delivering the baby, tying and cutting the umbilical cord at its placental insertion site, leaving the placenta in the uterus and waiting for its complete spontaneous resorption in women with placenta accreta spectrum (PAS). The uterine preservation rate with this approach is about 78%, and severe maternal morbidity about 6%; these rates are respectively lower and higher in subgroups of women with placenta percreta...
July 21, 2020: Best Practice & Research. Clinical Obstetrics & Gynaecology
Fengge Wang, Lihua Zhang, Fanyong Zhang, Jishui Wang, Yangping Wang, Dongmei Man
OBJECTIVES: In this retrospective study, we investigated whether first trimester serum placental growth factor (PIGF) differed amongst pregnancies with placenta previa-accreta and non-adherent placenta previa and healthy pregnancies. METHODS: In 1 January 2017-30 September 2019, a total of 177 pregnant females were included in the study, as follows: 35 cases of placenta previa-accreta, 30 cases of non-adherent placenta previa, and 112 cases of age and BMI-matched, healthy pregnant controls...
September 3, 2020: Placenta
Kensaku Mori, Mana Obata-Yasuoka, Tsukasa Saida, Keiko Nishida, Hiroaki Takahashi, Yoshihiko Hosokawa, Yohei Takei, Ayako Tsumagari, Miki Yoshida, Yutaku Kimura, Tetsuya Abe, Yoko Tsukuda, Shu Harada, Takahiro Kojima, Manabu Minami
PURPOSE: To compare n -butyl cyanoacrylate (NBCA) and gelatine sponge (GS) as embolic materials for prophylactic pelvic arterial embolisation during caesarean hysterectomy for placenta accreta spectrum (PAS). MATERIAL AND METHODS: This retrospective study comprised 12 women (age range, 23-42 years; mean, 34.1 years) who underwent caesarean hysterectomy for PAS. Following caesarean delivery, bilateral uterine and non-uterine parasitic arteries were embolized with GS in the first four cases (GS group) and primarily with NBCA mixed with iodized oil in the subsequent eight cases (NBCA group)...
September 9, 2020: Minimally Invasive Therapy & Allied Technologies: MITAT
Shaoqi Chen, Qingzi Chen, Xiya Du, Sumin Chen, Weiping Li, Shigao Chen
AIMS: Excessive placental invasion is a life-threatening obstetric disease. Determining the extent of placental villi invasion prenatally is crucial for formulating a surgical plan for pregnant women. The objective of this study was to explore the diagnostic accuracy of the Crystal Vue technique combined with two-dimensional (2D) ultrasound in detecting the degree of placenta accreta spectrum (PAS) located in the C-section scar area. MATERIALS AND METHODS: Twenty-seven pregnant women with a strong suspicion of PAS underwent 2D ultrasound combined with a Crystal Vue examination...
August 18, 2020: Medical Ultrasonography
M F Escobar, J C Gallego, D Nasner, K Gunawardana
The purpose of this review is to describe the panorama of placenta accreta spectrum (PAS) disorder management in low- and middle-income countries, providing information that allows for the improvement of maternal and perinatal outcomes in the management of this pathology. This spectrum of disorders is associated with implications of high morbidity and mortality, both maternal and perinatal, which is why clinical practice guidelines based on management are produced in settings where there is a wide range of available resources...
August 13, 2020: Best Practice & Research. Clinical Obstetrics & Gynaecology
Richard Hawkins, Matthew Evans, Sarah Hammond, Richard Hartopp, Emma Evans
The incidence of placenta accreta spectrum (PAS) is increasing and will become more commonly encountered by obstetric anaesthetists in the elective and emergency settings. Significant maternal and neonatal morbidity is associated with these disorders, and hence it is important for anaesthetists to have early involvement in perioperative planning. Major haemorrhage should be anticipated and requires robust perioperative preparation including Patient Blood Management (PBM) and use of intraoperative strategies for haemorrhage management wherever possible...
August 13, 2020: Best Practice & Research. Clinical Obstetrics & Gynaecology
C M Coutinho, V Giorgione, L Noel, B Liu, E Chandraharan, J Pryce, A P Frick, B Thilaganathan, A Bhide
OBJECTIVES: Maternal mortality related to the placenta accreta spectrum (PAS) disorders remain substantial when an unexpected diagnosis is made at delivery. The aim of this study was to evaluate the effectiveness of a routine contingent ultrasound screening program for PAS. METHODS: A retrospective study conducted between 2009 and 2019 involving two groups: a screening cohort of unselected women attending for routine mid-trimester ultrasound assessment and a diagnostic cohort comprised of referrals to the PAS diagnostic service with a suspected diagnosis of PAS in women with placenta previa and previous uterine surgery...
August 31, 2020: Ultrasound in Obstetrics & Gynecology
Yuwei Bao, Ying Pang, Ziyan Sun, Qian Li, Dazhong Tang, Liming Xia
OBJECTIVES: To investigate the diagnostic value of intravoxel incoherent motion (IVIM) DWI for placenta accreta by comparing diffusion and perfusion characteristics of placentas with accreta lesions (APs) with those of normal placentas (NPs). METHODS: Twenty-five pregnant women with AP and 24 with NP underwent 3-T magnetic resonance examinations with IVIM-DWI. The perfusion percentage (f), pseudo-diffusion coefficient (D*), and diffusion coefficient (D) values were calculated from different ROIs: the entire-plane of the AP (AP-ROI) and NP (NP-ROI) and the implanted (IR-ROI) and non-implanted region (NIR-ROI) of the AP...
August 30, 2020: European Radiology
Luke J King, A Dhanya Mackeen, Cara Nordberg, Michael J Paglia
INTRODUCTION: Maternal risk factors associated with placenta previa are well documented in the literature. However, there are limited studies identifying maternal characteristics associated with the persistence of placenta previa. The objective of the study was to determine maternal characteristics associated with the persistent placenta previa. METHODS: A retrospective cohort study was conducted in which 705 pregnant women diagnosed with low-lying placenta or placenta previa between 17 and 24 weeks gestation were identified from a single institution between 2003 and 2017...
August 6, 2020: Placenta
Emin Üstünyurt
Objective: Placenta accreta spectrum (PAS) is a potentially life-threatening condition characterized by the abnormal adherence of the placenta to the implantation site. We sought to evaluate the efficacy, surgical feasibility, risks, and advantages of local uterine resection in cases complicated with PAS. Materials and Methods: This study included 97 patients with PAS, which was confirmed during surgery and by histopathological examination between January 2013 and December 2019...
June 2020: Turkish Journal of Obstetrics and Gynecology
Nabih I Elkhouly, Ayman E Solyman, Mohamed E Anter, Zakaria F Sanad, Alaa N El Ghazaly, Hamed E Ellakwa
OBJECTIVE: To assess the efficacy and safety of a new surgical approach for uterine preservation among patients with placenta accreta spectrum in a low-resource setting. METHODS: The present prospective cohort included 63 women diagnosed with placenta accreta spectrum undergoing cesarean deliveries who desired future fertility at the obstetrics department of Menoufia University Hospital from January 2018 to November 2019. Surgical management involved direct bilateral uterine arteries clamping below placental bed after broad ligament opening by round ligaments division and ligation and gentle downward dissection of vesical from myometrial tissues from lateral aspect toward trigone of the bladder...
August 25, 2020: Journal of Maternal-fetal & Neonatal Medicine
Y M Dai, J Wei, Z Q Wang, X B Zhang, L Cheng, N Gu, Y L Hu
Objective: To access the effectiveness and safety of the intrauterine balloon tamponade verse gauze packing combined with temporary abdominal aortic balloon occlusion in the management of placenta accreta spectrum (PAS). Methods: This was an open-label, randomized controlled trial conducted in Nanjing Drum Tower Hospital. The patients suspected with PAS for uterine preservation surgery under the multidisciplinary team care were recruited between Aug 2015 and Jan 2018. When bleeding could not be achieved after fetus delivered, and a temporary abdominal aortic balloon occlusion and the compression sutures as needed, the women were randomly allocated 1∶1 into balloon tamponade ( n =81) or gauze packing ( n =80) group...
July 25, 2020: Zhonghua Fu Chan Ke za Zhi
S Tinari, D Buca, G Cali, I Timor-Tritsch, J Palacios-Jaraquemada, G Rizzo, A Lucidi, D Di Mascio, M Liberati, F D'Antonio
OBJECTIVES: To elucidate the risk factor, histopathological correlations and diagnostic accuracy of prenatal imaging in detecting posterior PAS. METHODS: MEDLINE, Embase and CINAHL were searched. Inclusion criteria were women with posterior PAS confirmed either at surgery or histopathological analysis. The outcomes explored were: risk factor for posterior PAS, histopathological correlation, and diagnostic accuracy of ultrasound and MRI in detecting these anomalies...
August 25, 2020: Ultrasound in Obstetrics & Gynecology
Valerie Bloomfield, Stacey Rogers, Nicholas Leyland
No abstract text is available yet for this article.
August 24, 2020: Canadian Medical Association Journal: CMAJ
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