Modern instrumental methods for the diagnosis of placental pathological invasion

DOI

https://dx.doi.org/10.18565/aig.2023.57

Kayumova A.V., Melkozerova O.A., Bashmakova N.V., Malgina G.B., Kosovtsova N.V.
Ural Research Institute of Maternity and Infancy Care, Ministry of Health of the Russian Federation, Yekaterinburg, Russia

Background: Over the past few decades, the placental pathological invasion-associated morbidity significantly increased, which is associated with an increase in the proportion of cesarean section. To prevent severe complications and to choose the optimal obstetric tactics, it is necessary to diagnose placental pathological invasion in time.
Objective: To study modern instrumental capacities in the diagnosis of placental pathological invasion.
Materials and methods: By using the keywords: “placental pathological invasion, “placental ingrowth”, “placenta accreta”, “placenta increta”, “placenta percreta”, “uterine scar”, “ultrasound study”, “magnetic resonance imaging (MRI)”, “elastography”, the authors analyzed the Russian and foreign literature databases: eLibrary, Medline/PubMed, Embase, Crossref, and the Russian Science Citation Index (RSCI). In accordance with the goal set, a total of 72 references were selected.
Results: The early ultrasound criteria may include отнести: visualization of the ovum in the uterine scar niche, in which the most part of the ovum is embedded in the myometrium and does not cross the endometrial zone, the ovum crosses the conventional serous line. The characteristic predictors for the second trimester are the presence of placental lacunae, the loss of the retroplacental hypoechoic zone, hypervascularizaton of the uterovesicular or retroplacental space, the spread of placental tissue into the myometrium or bladder, placental bridging vessels. The MRI criteria are dark intraplacental bands on the T2-weighted image, loss of a low-intensity retroplacental signal line on T2-weighted image, thinning/rupture of myometrial visualization, discontinuity of the contours of the bladder wall, focal exophytic placental mass, and the abnormal vascular network of the placental bed.
Conclusion: This review presents the significant diagnostic parameters of placental pathological invasion in different gestational periods, which have been identified by the modern visualization methods: ultrasound study and MRI. The prospects of elastography used in the diagnosis of placental pathological invasion require further investigations.

Authors’ contributions: Kayumova A.V., Melkozerova O.A. – the concept and design of the investigation; Kayumova A.V. – material collection and processing, writing the text; Bashmakova N.V., Melkozerova O.A., Malgina G.B., Kosovtsova N.V. – editing.
Conflicts of interest: The authors declare that there are no possible conflicts of interest.
Funding: State assignment for Research No. 056-00121-22-00.
For citation: Kayumova A.V., Melkozerova O.A., Bashmakova N.V.,
Malgina G.B., Kosovtsova N.V. Modern instrumental methods
for the diagnosis of placental pathological invasion.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2023; (6): 5-14 (in Russian)
https://dx.doi.org/10.18565/aig.2023.57

pathologically invasive placenta

placental ingrowth

placenta accretа

increta

percreta

uterine scar

ultrasound study

magnetic resonance imaging

elastrography

Full text (in Russian)

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Received 06.03.2023

Accepted 08.06.2023

Alena V. Kayumova, PhD, Leading Researcher, Head of the Medical Care Quality Control Department, Ural Research Institute of Maternity and Child Care,
Ministry of Health of the Russian Federation, +7(982)62-32-047, kaum-doc@mail.ru, https://orcid.org/0000-0003-2685-4285, 620028, Russia, Ekaterinburg, Repin str., 1.
Oksana A. Melkozerova, Dr. Med. Sci., Deputy Director for Science, Ural Research Institute of Maternity and Child Care, Ministry of Health of the Russian Federation, abolmed1@mail.ru, https://orcid.org/0000-0002-4090-0578, 620028, Russia, Ekaterinburg, Repin str., 1.
Nadezhda V. Bashmakova, Dr. Med. Sci., Professor, Chief Researcher, Ural Research Institute of Maternity and Child Care, Ministry of Health of the Russian Federation, bashmakovanv@niiomm.ru, https://orcid.org/0000-0001-5746-316X, 620028, Russia, Ekaterinburg, Repin str., 1.
Galina B. Malgina, Dr. Med. Sci., Professor, Director, Ural Research Institute of Maternity and Child Care, Ministry of Health of the Russian Federation, galinamalgina@mail.ru, https://orcid.org/0000-0002-5500-6296, 620028, Russia, Ekaterinburg, Repin str., 1.
Natalya V. Kosovtsova, Dr. Med. Sci., Head of the Department of Biophysical and Radiation Research Methods, Ural Research Institute of Maternity and Child Care,
Ministry of Health of the Russian Federation, kosovcovan@mail.ru, https://orcid.org/0000-0002-4670-798Х, 620028, Russia, Ekaterinburg, Repin str., 1.
Corresponding author: Alena V. Kayumova, kaum-doc@mail.ru

Modern instrumental methods for the diagnosis of placental pathological invasion

Kayumova A.V., Melkozerova O.A., Bashmakova N.V., Malgina G.B., Kosovtsova N.V.

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