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CC BY 4.0 · Rev Bras Ginecol Obstet 2021; 43(05): 347-350
DOI: 10.1055/s-0041-1731301
Editorial

Placenta Accreta Spectrum Disorders and Cesarean Scar Pregnancy Screening: Are we Asking the Right Questions?

Conrado Milani Coutinho 
1   Department of Gynecology and Obstetrics, Hospital das Clínicas, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
,
Laure Noel 
2   Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, Blackshaw Road, London, United Kingdom
,
Veronica Giorgione 
3   Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, United Kingdom
,
Lígia Conceição Assef Marçal 
1   Department of Gynecology and Obstetrics, Hospital das Clínicas, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
,
Amar Bhide 
2   Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, Blackshaw Road, London, United Kingdom
,
Basky Thilaganathan 
2   Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, Blackshaw Road, London, United Kingdom
3   Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, United Kingdom
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According to the World Health Organization, approximately 295,000 women died in 2017 during the antenatal and postpartum period. The vast majority (94%) of these cases occurred in low- and middle-income countries, with an estimate of 810 daily deaths from preventable causes.[1] Obstetric hemorrhage is the leading cause of maternal mortality worldwide and, among its key etiologies, placenta accreta spectrum (PAS) disorders have been increasing in prevalence concurrently with the global rise in the proportion of Cesarean deliveries and rates have currently being reported between 0.01% to 1.1% of pregnancies.[2] [3] [4] [5] Accurate screening and diagnosis of PAS is of utmost importance for timely antenatal referral to tertiary hospitals and management by specialized multidisciplinary teams, which has been associated with a reduction in its associated morbimortality.[6] Although ultrasound diagnosis of PAS can be reliably done in centers with expertise, with an accuracy of approximately 90%,[7] [8] in non-specialized facilities this rate falls to 50%, mainly due to insufficient clinical suspicion and/or knowledge of risk factors.[9] [10] Therefore, effective and systematic screening and diagnostic protocols for PAS should be implemented in all maternal-fetal health care services in order to prevent adverse outcomes related to undiagnosed PAS disorders. The purpose of this article is to highlight the importance of basic questions that should be incorporated by all sonographers while performing routine obstetrical ultrasound to improve the detection of PAS.



Publikationsverlauf

Artikel online veröffentlicht:
28. Juni 2021

© 2021. Federação Brasileira de Ginecologia e Obstetrícia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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