Influence of prenatal diagnosis of abnormally invasive placenta on maternal outcome : systematic review and meta-analysis
Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd..
OBJECTIVE: To ascertain the impact of prenatal diagnosis on surgical outcome of women affected by abnormally invasive placenta (AIP).
METHODS: MEDLINE, EMBASE, CINAHL and Cochrane databases were searched. Observed outcomes included: gestational age at birth (weeks), amount of blood loss (L), units of red blood cells (RBC), platelets (PLT) and fresh frozen plasma (FFP) transfused, length of stay in hospital and the intensive care unit (ICU) (days), urinary tract injury and infection. Only studies reporting the occurrence of any of the explored outcomes in women with a prenatal compared with an intrapartum diagnosis of AIP were considered eligible for inclusion. Random-effect head-to-head meta-analyses were used to analyze the data.
RESULTS: Thirteen studies were included. Women with a prenatal diagnosis of AIP had less blood loss during surgery (mean difference (MD), -0.87; 95% CI, -1.5 to -0.23), had fewer units of RBC (MD, -1.45; 95% CI, -2.9 to -0.04) and FFP (MD, -1.73; 95% CI, -3.3 to -0.2) transfused, and delivered earlier (MD, 1.33 weeks; 95% CI, -2.23 to -0.43) compared with those with an intrapartum diagnosis. The risk of admission to an ICU and length of in-hospital and in-ICU stay were not different between the groups. Prenatal diagnosis of AIP was associated with a higher risk of urinary-tract injury (odds ratio, 2.5; 95% CI, 1.3-4.6), mainly due to the higher prevalence of placenta percreta in the group with AIP diagnosed prenatally.
CONCLUSION: Prenatal diagnosis of AIP is associated with reduced hemorrhagic morbidity compared with cases in which such anomalies are detected at delivery. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2018 |
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| Erschienen: |
2018 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:52 |
|---|---|
| Enthalten in: |
Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology - 52(2018), 3 vom: 12. Sept., Seite 304-309 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Buca, D [VerfasserIn] |
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| Links: |
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| Themen: |
Abnormally invasive placenta |
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| Anmerkungen: |
Date Completed 18.12.2018 Date Revised 18.12.2018 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1002/uog.19070 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM283085703 |
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| 100 | 1 | |a Buca, D |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Influence of prenatal diagnosis of abnormally invasive placenta on maternal outcome |b systematic review and meta-analysis |
| 264 | 1 | |c 2018 | |
| 336 | |a Text |b txt |2 rdacontent | ||
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| 500 | |a Date Completed 18.12.2018 | ||
| 500 | |a Date Revised 18.12.2018 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd. | ||
| 520 | |a OBJECTIVE: To ascertain the impact of prenatal diagnosis on surgical outcome of women affected by abnormally invasive placenta (AIP) | ||
| 520 | |a METHODS: MEDLINE, EMBASE, CINAHL and Cochrane databases were searched. Observed outcomes included: gestational age at birth (weeks), amount of blood loss (L), units of red blood cells (RBC), platelets (PLT) and fresh frozen plasma (FFP) transfused, length of stay in hospital and the intensive care unit (ICU) (days), urinary tract injury and infection. Only studies reporting the occurrence of any of the explored outcomes in women with a prenatal compared with an intrapartum diagnosis of AIP were considered eligible for inclusion. Random-effect head-to-head meta-analyses were used to analyze the data | ||
| 520 | |a RESULTS: Thirteen studies were included. Women with a prenatal diagnosis of AIP had less blood loss during surgery (mean difference (MD), -0.87; 95% CI, -1.5 to -0.23), had fewer units of RBC (MD, -1.45; 95% CI, -2.9 to -0.04) and FFP (MD, -1.73; 95% CI, -3.3 to -0.2) transfused, and delivered earlier (MD, 1.33 weeks; 95% CI, -2.23 to -0.43) compared with those with an intrapartum diagnosis. The risk of admission to an ICU and length of in-hospital and in-ICU stay were not different between the groups. Prenatal diagnosis of AIP was associated with a higher risk of urinary-tract injury (odds ratio, 2.5; 95% CI, 1.3-4.6), mainly due to the higher prevalence of placenta percreta in the group with AIP diagnosed prenatally | ||
| 520 | |a CONCLUSION: Prenatal diagnosis of AIP is associated with reduced hemorrhagic morbidity compared with cases in which such anomalies are detected at delivery. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Meta-Analysis | |
| 650 | 4 | |a Systematic Review | |
| 650 | 4 | |a abnormally invasive placenta | |
| 650 | 4 | |a outcome | |
| 650 | 4 | |a placenta accreta | |
| 650 | 4 | |a placenta increta | |
| 650 | 4 | |a placenta percreta | |
| 650 | 4 | |a prenatal diagnosis | |
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| 700 | 1 | |a Calì, G |e verfasserin |4 aut | |
| 700 | 1 | |a Forlani, F |e verfasserin |4 aut | |
| 700 | 1 | |a Caisutti, C |e verfasserin |4 aut | |
| 700 | 1 | |a Flacco, M E |e verfasserin |4 aut | |
| 700 | 1 | |a Manzoli, L |e verfasserin |4 aut | |
| 700 | 1 | |a Familiari, A |e verfasserin |4 aut | |
| 700 | 1 | |a Scambia, G |e verfasserin |4 aut | |
| 700 | 1 | |a D'Antonio, F |e verfasserin |4 aut | |
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