Telemedicine ultrasound assessment for placenta accreta spectrum: Utility and interobserver reliability of asynchronous remote imaging review.

Objective: Management of patients with placenta accreta spectrum (PAS) by trained multidisciplinary teams is associated with improved outcomes. Ultrasound can predict intraoperative risks, but expert ultrasound imaging of PAS is often limited. Telemedicine is used increasingly in obstetrics, permitting expert consultation when essential resources are not available locally.

The use of pressure balloons in the treatment of first trimester cesarean scar pregnancy.

Cesarean scar pregnancy (CSP) is among the most severe complications of cesarean delivery. CSP refers to the abnormal implantation of the gestational sac in the area of the prior cesarean delivery (CD), potentially leading to severe hemorrhage, uterine rupture, or development of placenta accreta spectrum disorders (PAS). The management of women with CSP has not been standardized yet.

Urinary tract injuries during surgery for placenta accreta spectrum disorders.

Objective: The main purpose of this study was to report the incidence of lower urinary tract injuries (UTI) during cesarean section (CS) hysterectomy in cases of Placenta Accreta Spectrum (PAS) disorders. Study design Retrospective analysis including all women with a prenatal diagnosis of PAS between January 2010 and December 2020. A dedicated multidisciplinary team was involved to define a tailored management for each patient.

Placenta accreta spectrum disorders clinical practice guidelines: A systematic review.

Objectives: To objectively assess the quality of the published clinical practice guidelines (CPGs) on the management of pregnancies complicated by placenta accreta spectrum (PAS)disorders.

Methods: MEDLINE, Embase, Scopus, and ISI Web of Science databases were searched. The following aspects related to the management of pregnancies with suspected PAS disorders were evaluated: risk factors for PAS, prenatal diagnosis, role of interventional radiology and ureteral stenting, and optimal surgical management.

Abnormal placenta implantation. Integration between first- and third-trimester imaging in predicting the severity of Placenta Accreta Spectrum (PAS) disorders.

Placenta accreta spectrum (PAS) disorders are pathological conditions correlated to a high risk of adverse maternal surgical outcomes, especially if not diagnosed. In the last 10 years, the literature interest for prenatal diagnosis of PAS disorders has been noticeably greater. More recently, significant progression in prenatal imaging techniques permitted an increase of early identified cases and a more accurate diagnosis of these anomalies, especially in women with multiple risk factors.

Vitamin D and Male Reproduction: Updated Evidence Based on Literature Review.

The purpose of this study was to clarify the vitamin D (VD) effect on male infertility. Our research was conducted using the following electronic databases: MEDLINE, Embase, Web of Science, Scopus, ClinicalTrials.gov, and Cochrane Library.

Placenta accreta spectrum disorders in twin pregnancies as an under reported clinical entity: a case series and systematic review.

Recent reports suggested a potential association between twin pregnancy and the occurrence of placenta accreta spectrum (PAS) disorders. Despite this, scarce data on PAS disorders in twins has been reported in the published literature. We present a series of twelve twin pregnancies complicated by PAS from two large institutions over 5 years.

Role of balloon tamponade during cesarean section in women with placenta previa: a systematic review and meta-analysis.

Introduction: To explore the role of balloon tamponade insertion in pregnancies complicated by placenta previa.

Evidence Acquisition: Medline, Embase and ClinicalTrials.gov databases were searched electronically on October 17.

Placenta Accreta Spectrum Disorder in a Patient with Six Previous Caesarean Deliveries: Step by Step Management.

The definition (PAS) introduced by FIGO (International Federation of Gynaecology and Obstetrics) indicates an abnormal, pathological adherence or invasion of the placenta. The growing worldwide incidence of this pathological entity, and the possible serious correlated surgical risks, has caused a significant increase in attention among the scientific community. Previous caesarean delivery and presence of placenta previa are the main risk factors for the onset of PAS.

Systematic review and meta-analysis on placenta accreta spectrum disorders in twin pregnancies: risk factors, detection rate and histopathology.

Introduction: The occurrence of PAS has been recently associated with the presence of twin pregnancy. Aim of this review is to report the risk factors, histopathological correlation, diagnostic accuracy of prenatal ultrasound and clinical outcome of twin pregnancies complicated by placenta accreta spectrum (PAS) disorders.

Evidence Acquisition: PubMed, Embase, Cinahl, Clinical Trial.

Radical surgery including the role of an interval hysterectomy.

The incidence of placenta accrete spectrum (PAS) disorders is increasing worldwide. Pregnancies complicated by PAS are at a high risk of intrapartum surgical complications, mainly due to severe maternal hemorrhage, potentially leading to death, thus highlighting the need for a tailored an appropriate surgical management for these women. Despite its clinical relevance, there are still unanswered questions regarding the surgical management of women with PAS.

Evaluation of the Tramline Sign in the Prediction of Placenta Accreta Spectrum and Perioperative Outcomes in Anterior Placenta Previa.

Purpose:  To evaluate perioperative outcomes and the prognostic role of the tramline sign in a cohort of women with anterior placenta previa.

Materials And Methods:  Retrospective analysis of 3D ultrasound volumes from women with anterior placenta previa who underwent ultrasound examination beyond 32 weeks. 3D and 3D color volumes were obtained from a sagittal section of the uterus bisecting a partially full bladder and processed using Crystal Vue and Crystal Vue Flow rendering to look for the "tramline sign".

Outcome of cesarean scar pregnancy according to gestational age at diagnosis: A systematic review and meta-analysis.

Objective: The association between the most severe types of placenta accreta spectrum disorders and caesarean scar pregnancy (CSP) poses the question of whether early diagnosis may impact the clinical outcome of these anomalies. The aim of this study is to report the outcome of cesarean scar pregnancy (CSP) diagnosed in the early (≤9 weeks) versus late (>9 weeks) first trimester of pregnancy.

Study Design: Medline, Embase and Clinicaltrail.

Reproductive outcome after cesarean scar pregnancy: A systematic review and meta-analysis.

Introduction: To evaluate subsequent reproductive among women with a prior cesarean scar pregnancy (CSP).

Material And Methods: MEDLINE, Embase and ClinicalTrials.gov databases were searched.

Evaluation of perioperative complications using a newly described staging system for placenta accreta spectrum.

Introduction: The antenatal diagnosis of placenta accreta spectrum (PAS) is in large part subjective and based on expert interpretation. The aim of this study was to externally evaluate a recently developed staging system based on specific and defined prenatal ultrasound (US) features in a cohort of women at risk of PAS undergoing specialist prenatal US, in particular relating to surgical morbidity at delivery.

Materials And Methods: Database study of cases with confirmed placenta previa.

First-trimester treatment of cesarean scar pregnancy using a cervical ripening-double-balloon catheter: A case report.

Cesarean scar pregnancies are relatively rare. In the first trimester, if the decision is made to terminate the pregnancy, it should be done as soon as possible to avoid complications. We report a successful termination of a live, 6 weeks and 4 days cesarean scar pregnancy using a double-balloon cervical ripening catheter in a patient with two previous cesarean deliveries.

Cesarean Scar Pregnancy: Patient Counseling and Management.

There is no universally agreed upon and adopted management protocol supported by professional societies in the United States or around the world for the treatment of cesarean scar pregnancy. There is a wide range of management options in the literature, and many of them can to lead to severe bleeding complications, which can result in loss of fertility or even maternal death. If inadequately managed, it can lead to untoward complications throughout all 3 trimesters of the pregnancy.

Cesarean Scar Pregnancy: Diagnosis and Pathogenesis.

Cesarean scar pregnancy is a potentially dangerous consequence of a previous cesarean delivery. If unrecognized and inadequately managed, it can lead to untoward complications throughout all three trimesters of the pregnancy. The rate of occurrence parallels the mounting rate of cesarean sections.

Updates on the management of placenta accreta spectrum.

Placenta accreta spectrum (PAS) disorders is a multifactorial process that encompasses a heterogeneous group of conditions characterized by an abnormal invasion of trophoblastic tissue through the myometrium and uterine serosa. PAS is associated with a high burden of adverse maternal outcomes including severe life-threatening hemorrhage, need for blood transfusion, damage to adjacent organs, and death. Prenatal screening of PAS is mandatory so that women may be counselled about the severity of this condition to plan management with a multidisciplinary team and delivery in a specialized center.

Minimally Invasive Treatment of Cesarean Scar and Cervical Pregnancies Using a Cervical Ripening Double Balloon Catheter: Expanding the Clinical Series.

The efficacy of treating cesarean scar pregnancies and cervical pregnancies with the Cook® cervical ripening balloon catheter, in a multicenter office-based setting is reported. Thirty-eight women were treated. Insertion of the catheter was performed under real-time ultrasound guidance.

Risk factors for abnormally invasive placenta: a systematic review and meta-analysis.

To explore the strength of association between different maternal and pregnancy characteristics and the occurrence of abnormally invasive placenta (AIP). Pubmed, Embase, CINAHL databases were searched. The risk factors for AIP explored were: obesity, age >35 years, smoking before or during pregnancy, placenta previa, prior cesarean section (CS), placenta previa and prior CS, prior uterine surgery, abortion and uterine curettage, fertilization (IVF) pregnancy and interval between a previous CS, and a subsequent pregnancy.