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Multicenter Study
. 2023 Mar;160(3):955-961.
doi: 10.1002/ijgo.14399. Epub 2022 Aug 28.

Placenta accreta spectrum ultrasound stage and fetal growth

Helena C Bartels  1 , Jennifer M Walsh  1   2 , Clare O'Connor  1 , Peter McParland  1   2 , Stephen Carroll  1 , Shane Higgins  1   2 , Karen M Mulligan  1 , Paul Downey  1 , David Brophy  1 , Gabrielle Colleran  1 , Claire Thompson  3 , Tom Walsh  3 , Donal J O'Brien  1   3 , Donal J Brennan  2   3 , Ruaidhri McVey  1   3 , Fionnuala M McAuliffe  1   2 , Jennifer Donnelly  4 , Siobhan M Corcoran  1   2
Affiliations
Multicenter Study

Placenta accreta spectrum ultrasound stage and fetal growth

Helena C Bartels et al. Int J Gynaecol Obstet. 2023 Mar.

Abstract

Objective: to evaluate fetal growth in pregnancies complicated by placenta accreta spectrum (PAS) and to compare fetal growth between cases stratified by ultrasound stage of PAS.

Methods: This was a prospective multicenter cohort study of women diagnosed with PAS between January 2018 and December 2021. We grouped participants into cases by ultrasound stage (PAS stage 1-3) and controls (PAS0). Fetal growth centiles at three timepoints with median gestational ages of 21 ± 1 weeks (interquartile range [IQR], 20 ± 1-22 ± 0 weeks), 28 ± 0 weeks (IQR, 27 ± 0-28 ± 5 weeks), and 33 ± 0 weeks (IQR, 32 ± 1-34 ± 0 weeks) and birth weight centiles were compared between cases and controls and between those with PAS stratified by ultrasound stage.

Results: A total of 53 women met inclusion criteria, with a mean age of 37 years (standard deviation, ±4.0 years) and body mass index of 27 kg/m2 (standard deviation, ±5.8 kg/m2 ). Median (IQR) fetal weight centiles were around the 50th centile at each timepoint, with no difference between groups. The incidence of small for gestational age (birth weight ≤ 10th percentile) and large for gestational age (birth weight ≥ 90th percentile) was 11.3% (n = 6) and 15.1% (n = 8), respectively, with no differences by ultrasound stage. The median birth weight centile was 64 (IQR, 26-85), with no differences between cases and controls or by ultrasound stage.

Conclusions: In our cohort, a diagnosis of PAS was not associated with fetal growth restriction.

Keywords: birth weight; fetal growth; placenta accreta spectrum; ultrasound stage.

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Conflict of interest statement

The authors have no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Maternal outcomes and placenta accreta spectrum (PAS) ultrasound stage. The black line denotes the median and the blue box denotes the interquartile range (IQR, 25th–75th percentiles). The estimated blood loss was higher in the PAS3 group compared with the PAS0 (P = 0.008) and PAS2 (P = 0.050) groups. There were no significant differences in red cell concentrate (RCC) units transfused between groups.
FIGURE 2
FIGURE 2
Fetal outcomes and placenta accreta spectrum (PAS) ultrasound stage. The black line denotes the median and the blue box denotes the interquartile range (IQR, 25th–75th percentiles). PAS3 was associated with a significantly earlier median gestation at delivery compared with PAS1 (P = 0.003) and PAS2 (P = 0.002). EFW, estimated fetal weight.
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