Abstract
Early screening for placenta accreta spectrum (PAS) is not established in Canada,
yet has been demonstrated with a 2-stage strategy in patients classified as at risk
at the nuchal translucency examination. We performed a retrospective analysis of women
with singleton pregnancies who had first-trimester screening and subsequently had
a pathology-confirmed PAS. We sought those who met high-risk clinical criteria for
PAS: previous uterine surgeries and an anterior low-lying placenta. Over 80% of women
met both high-risk criteria at the nuchal translucency examination. Lack of early
recognition and risk stratification resulted in a late median gestational age at suspicion
and diagnosis of PAS.
Résumé
Il n’existe aucun protocole de dépistage précoce du placenta du spectre accreta (PSA)
au Canada. Toutefois, il s’avère efficace dans une stratégie en deux étapes chez les
patientes à risque selon les observations à l’examen de la clarté nucale. Nous avons
effectué une analyse rétrospective de femmes ayant subi un dépistage au premier trimestre
en contexte de grossesse monofśtale puis reçu un diagnostic confirmé de PSA. Nous
avons ciblé les patientes répondant aux critères cliniques de risque élevé de PSA,
notamment celles avec antécédent de chirurgie utérine et un placenta bas inséré antérieur.
Plus de 80 % de ces femmes répondaient aux deux critères lors de l’examen de la clarté
nucale. L’absence de détection précoce et de classification du risque a fait en sorte
que le PSA a été soupçonné et diagnostiqué à un âge gestationnel médian avancé.
Keywords
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Article info
Publication history
Published online: March 21, 2022
Accepted:
March 2,
2022
Received:
November 24,
2021
Footnotes
Disclosures: The authors declare they have nothing to disclose.
All authors have indicated they meet the journal’s requirements for authorship.
Identification
Copyright
© 2022 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada. Published by Elsevier Inc. All rights reserved.
