Placenta percreta evaluated by MRI: correlation with maternal morbidity.

Area of Science:

• Radiology
• Obstetrics
• Gynecologic Imaging

Background:

• Placenta percreta (PP) poses significant risks during pregnancy.
• Accurate assessment of PP invasion is crucial for surgical planning and patient outcomes.

Purpose of the Study:

• To evaluate the capability of Magnetic Resonance Imaging (MRI) in depicting placenta percreta (PP) invasion topography.
• To explore the correlation between PP invasion topography and maternal outcomes.

Main Methods:

• Retrospective study of 55 patients with confirmed placenta percreta.
• Two radiologists assessed PP invasion topography on MRI (S1, S2, parametrial, bladder, cervical).
• Chi-square statistic analyzed the correlation between invasion topography and maternal outcomes.

Main Results:

• MRI demonstrated high sensitivity and specificity (87.5-100%) for delineating PP invasion topography.
• MRI achieved 100% specificity for parametrial, bladder, and cervical invasion.
• S2 invasion was associated with higher rates of cesarean hysterectomy, ureteral injuries, ICU admission, and blood transfusions compared to S1 invasion.

Conclusions:

• MRI is effective in predicting the invasion topography of placenta percreta.
• Patients with S2, parametrial, bladder, or cervical invasion experience more severe maternal morbidity.