Key result
Anterior placental location in placenta accreta spectrum was associated with a higher rate of invasive forms (81.4% vs 36.5% and 28.6%, p<0.05) but similar major perinatal outcomes.
Why the study?
To explore the prenatal diagnosis, clinical characteristics, and perinatal outcomes of placenta accreta spectrum across different placental locations.
Do clinical characteristics and perinatal outcomes differ based on placental location in pregnant women with placenta accreta spectrum?
Cohort (n=118)
Yes
Do clinical characteristics and perinatal outcomes differ based on placental location in pregnant women with placenta accreta spectrum?
Anterior placenta location in placenta accreta spectrum is associated with higher rates of invasive disease and prenatal suspicion, though major perinatal outcomes do not significantly differ by location.
Anterior placental location may aid PAS risk stratification; leaves open whether site-specific protocols improve outcomes.
Objective: To explore the prenatal diagnosis, clinical characteristics, and perinatal outcomes of placenta accreta spectrum in different placental locations. Methods: This was a retrospective cohort study. Pregnant women who delivered at two tertiary referral hospitals from January 2013 to December 2022 and were ultimately pathologically diagnosed with placenta accreta spectrum were included. They were divided into three groups based on different placental locations (anterior, posterior, and lateral wall/fundus). The differences in prenatal diagnosis, clinical characteristics, and perinatal outcomes among the three groups were compared. Results: There were 115,470 deliveries in a ten-year period at the two hospitals, and 118 case patients were confirmed to have a pathologically diagnosed placenta accreta spectrum. The posterior placenta group had a lower rate of placenta previa (76.9% vs 94.9% vs 100%, p<0.05) and a higher gestational age at delivery (36.4±2.45 vs 34.91±1.76 vs 34.31±3.41, p<0.05) compared to the other two groups. The anterior placenta group had a significantly higher rate of invasive (increta/percreta) form placenta accreta spectrum (81.4% vs 36.5% vs 28.6%, p<0.05) and planned cesarean section (96.6% vs 80.8% vs 71.4%, p<0.05) compared to the other two groups. In terms of prenatal diagnosis, the anterior placenta group had a significantly higher rate of placenta accreta spectrum prenatal suspicion rate compared to the other two groups (86.4% vs 36.5% vs 57.1%, p<0.05). The posterior placenta group had a lower rate of preoperative abdominal aortic balloon placement compared to the other two groups (5.8% vs 28.8% vs 28.6%, p<0.05). There were no statistically significant differences among the three groups in primary perinatal outcomes, though the anterior placenta group had a longer postoperative hospital stay. Conclusion: The prenatal diagnosis rate and proportion of invasive form of placenta accreta spectrum occurring in non-anterior placenta are relatively lower than anterior placenta. There were no significant differences in major perinatal outcomes among the three groups.
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Feng et al. (2024) conducted a cohort in Placenta accreta spectrum (n=118). Anterior placental location vs. Posterior and lateral wall/fundus placental locations was evaluated on Primary perinatal outcomes. Anterior placental location in placenta accreta spectrum was associated with a higher rate of invasive forms (81.4% vs 36.5% and 28.6%, p<0.05) but similar major perinatal outcomes.
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