Jauniaux, E;
Hussein, AM;
Einerson, BD;
Silver, RM;
(2022)
Debunking 20th century myths and legends about the diagnosis of placenta accreta spectrum.
Ultrasound in Obstetrics and Gynecology
, 59
(4)
pp. 417-423.
10.1002/uog.24890.
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Abstract
Placenta accreta is a spectrum disorder, which was first defined in 1937 by Irving and Hertig1 clinically as having difficulties in delivery of the placenta and histologically by the absence of decidua with direct attachment of placental villi to the superficial myometrium1. Placenta accreta is a congenital disorder, which means that the process leading to the abnormal attachment of the placenta to the uterine wall develops during pregnancy2, 3. Although both the clinical and histological features of accreta placentation appear on a spectrum, meaning that patients are affected in different ways and to different degrees, the definition of Irving and Hertig has prevailed for over 80 years. In particular, histopathologic studies have used the absence of decidua with direct attachment of the villous tissue to the superficial myometrium as the gold standard for the diagnosis of placenta accreta spectrum (PAS), including when reporting on more severe PAS grades, i.e. placenta increta and placenta percreta4-7. The concept of an intact fibrin layer serving as a barrier to abnormal placental invasion extends even further back, to 1887, the year of Raissa Nitabuch's dissertation on the topic of normal placental circulation6. Most authors of clinical studies describe cases of PAS as ‘confirmed by histopathology’, without providing any detailed description of the methodology used. This has led to considerable heterogeneity in epidemiological data with wide variations in the prevalence of PAS and incidence of its different grades in general population studies8, 9.
| Type: | Article |
|---|---|
| Title: | Debunking 20th century myths and legends about the diagnosis of placenta accreta spectrum |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1002/uog.24890 |
| Publisher version: | https://doi.org/10.1002/uog.24890 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher's terms and conditions. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health > Reproductive Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10148975 |
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