Placenta Accreta Spectrum Prenatal Diagnosis Performance: Are Ultrasound False-positive Results Acceptable in Limited-resources Settings?
Abstract Objective The immediate referral of patients with risk factors for placenta accreta spectrum (PAS) to specialized centers is recommended, thus favoring an early diagnosis and an interdisciplinary management. However, diagnostic errors are frequent, even in referral centers (RCs). We sought to evaluate the performance of the prenatal diagnosis for PAS in a Latin American hospital. Methods A retrospective descriptive study including patients referred due to the suspicion of PAS was conducted. Data from the prenatal imaging studies were compared with the final diagnoses (intraoperative and/or histological). Results A total of 162 patients were included in the present study. The median gestational age at the time of the first PAS suspicious ultrasound was 29 weeks, but patients arrived at the PAS RC at 34 weeks. The frequency of false-positive results at referring hospitals was 68.5%. Sixty-nine patients underwent surgery based on the suspicion of PAS at 35 weeks, and there was a 28.9% false-positive rate at the RC. In 93 patients, the diagnosis of PAS was ruled out at the RC, with a 2.1% false-negative frequency. Conclusion The prenatal diagnosis of PAS is better at the RC. However, even in these centers, false-positive results are common; therefore, the intraoperative confirmation of the diagnosis of PAS is essential.
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Federação Brasileira das Sociedades de Ginecologia e Obstetrícia
2022
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oai:scielo:S0100-720320220009008382022-12-19Placenta Accreta Spectrum Prenatal Diagnosis Performance: Are Ultrasound False-positive Results Acceptable in Limited-resources Settings?Nieto-Calvache,Albaro JoséBenavides-Calvache,Juan PabloHidalgo,AlejandraPadilla,NataliaLópez-Tenorio,JaimeVictoria,AlejandroRengifo,MartinMejía,MauricioVergara-Galliadi,Lina MaríaSinisterra-Díaz,Stiven ErnestoMaya,JulianaZambrano,María AndreaBurgos-Luna,Juan Manuel placenta accreta ultrasonography false positive prenatal ultrasonic diagnosis operative surgical procedure Abstract Objective The immediate referral of patients with risk factors for placenta accreta spectrum (PAS) to specialized centers is recommended, thus favoring an early diagnosis and an interdisciplinary management. However, diagnostic errors are frequent, even in referral centers (RCs). We sought to evaluate the performance of the prenatal diagnosis for PAS in a Latin American hospital. Methods A retrospective descriptive study including patients referred due to the suspicion of PAS was conducted. Data from the prenatal imaging studies were compared with the final diagnoses (intraoperative and/or histological). Results A total of 162 patients were included in the present study. The median gestational age at the time of the first PAS suspicious ultrasound was 29 weeks, but patients arrived at the PAS RC at 34 weeks. The frequency of false-positive results at referring hospitals was 68.5%. Sixty-nine patients underwent surgery based on the suspicion of PAS at 35 weeks, and there was a 28.9% false-positive rate at the RC. In 93 patients, the diagnosis of PAS was ruled out at the RC, with a 2.1% false-negative frequency. Conclusion The prenatal diagnosis of PAS is better at the RC. However, even in these centers, false-positive results are common; therefore, the intraoperative confirmation of the diagnosis of PAS is essential.info:eu-repo/semantics/openAccessFederação Brasileira das Sociedades de Ginecologia e ObstetríciaRevista Brasileira de Ginecologia e Obstetrícia v.44 n.9 20222022-09-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-72032022000900838en10.1055/s-0042-1751061 |
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Nieto-Calvache,Albaro José Benavides-Calvache,Juan Pablo Hidalgo,Alejandra Padilla,Natalia López-Tenorio,Jaime Victoria,Alejandro Rengifo,Martin Mejía,Mauricio Vergara-Galliadi,Lina María Sinisterra-Díaz,Stiven Ernesto Maya,Juliana Zambrano,María Andrea Burgos-Luna,Juan Manuel |
| spellingShingle |
Nieto-Calvache,Albaro José Benavides-Calvache,Juan Pablo Hidalgo,Alejandra Padilla,Natalia López-Tenorio,Jaime Victoria,Alejandro Rengifo,Martin Mejía,Mauricio Vergara-Galliadi,Lina María Sinisterra-Díaz,Stiven Ernesto Maya,Juliana Zambrano,María Andrea Burgos-Luna,Juan Manuel Placenta Accreta Spectrum Prenatal Diagnosis Performance: Are Ultrasound False-positive Results Acceptable in Limited-resources Settings? |
| author_facet |
Nieto-Calvache,Albaro José Benavides-Calvache,Juan Pablo Hidalgo,Alejandra Padilla,Natalia López-Tenorio,Jaime Victoria,Alejandro Rengifo,Martin Mejía,Mauricio Vergara-Galliadi,Lina María Sinisterra-Díaz,Stiven Ernesto Maya,Juliana Zambrano,María Andrea Burgos-Luna,Juan Manuel |
| author_sort |
Nieto-Calvache,Albaro José |
| title |
Placenta Accreta Spectrum Prenatal Diagnosis Performance: Are Ultrasound False-positive Results Acceptable in Limited-resources Settings? |
| title_short |
Placenta Accreta Spectrum Prenatal Diagnosis Performance: Are Ultrasound False-positive Results Acceptable in Limited-resources Settings? |
| title_full |
Placenta Accreta Spectrum Prenatal Diagnosis Performance: Are Ultrasound False-positive Results Acceptable in Limited-resources Settings? |
| title_fullStr |
Placenta Accreta Spectrum Prenatal Diagnosis Performance: Are Ultrasound False-positive Results Acceptable in Limited-resources Settings? |
| title_full_unstemmed |
Placenta Accreta Spectrum Prenatal Diagnosis Performance: Are Ultrasound False-positive Results Acceptable in Limited-resources Settings? |
| title_sort |
placenta accreta spectrum prenatal diagnosis performance: are ultrasound false-positive results acceptable in limited-resources settings? |
| description |
Abstract Objective The immediate referral of patients with risk factors for placenta accreta spectrum (PAS) to specialized centers is recommended, thus favoring an early diagnosis and an interdisciplinary management. However, diagnostic errors are frequent, even in referral centers (RCs). We sought to evaluate the performance of the prenatal diagnosis for PAS in a Latin American hospital. Methods A retrospective descriptive study including patients referred due to the suspicion of PAS was conducted. Data from the prenatal imaging studies were compared with the final diagnoses (intraoperative and/or histological). Results A total of 162 patients were included in the present study. The median gestational age at the time of the first PAS suspicious ultrasound was 29 weeks, but patients arrived at the PAS RC at 34 weeks. The frequency of false-positive results at referring hospitals was 68.5%. Sixty-nine patients underwent surgery based on the suspicion of PAS at 35 weeks, and there was a 28.9% false-positive rate at the RC. In 93 patients, the diagnosis of PAS was ruled out at the RC, with a 2.1% false-negative frequency. Conclusion The prenatal diagnosis of PAS is better at the RC. However, even in these centers, false-positive results are common; therefore, the intraoperative confirmation of the diagnosis of PAS is essential. |
| publisher |
Federação Brasileira das Sociedades de Ginecologia e Obstetrícia |
| publishDate |
2022 |
| url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-72032022000900838 |
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