first trimester ultrasound and placenta accreta
This is a prospective observational cohort of women who are diagnosed with low pregnancy implantation in the first trimester. We will sonographically evaluate these patients in each trimester and apply the criteria stated in the Introduction and Purpose section and described in the literature (1,2,3) to assess our ability to predict degree of placental invasion. Delivery data will also be collected in order to evaluate which criteria best predicts abnormal placentation. We will compare the outcomes of patients with a prior cesarean scar, otherwise deemed as high risk for placental invasion, to the outcomes of patients with an unscarred uterus as well as to those who had a low implantation of their pregnancy but no pathological invasion at delivery. We plan on having to consent a total of 300 patients to obtain 200 patients who agree to be included.
1. Twickler DM, Lucus MJ, Balis AB, et al. The Journal of Maternal-Fetal Medicine 2000;9:330-335.
2. Finberg HJ, Williams JW. Placenta Accreta: Prospective Sonographic Diagnosis in Patients with Placenta Previa and Prior Cesarean Section. J Ultrasound Med, 1993;11:333-343.
3. Ballas J, Pretorius D, Hull A, et al. Identifying Sonographic Markers for Placenta Accreta in the First Trimester. J Ultrasound Med 2012;31:1835-1841.
Female gravidas with low-implantation of the gestational sac, irregardless of the presence of a fetal pole during the first trimester (= 14 weeks and 0 days).