Improving the Accuracy of Diagnosing Placenta Previa on Transvaginal Ultrasound by Distinguishing between the Uterine Isthmus and Cervix: A Prospective Multicenter Observational Study

Junichi Hasegawa, Ikuno Kawabata, Yoshiharu Takeda, Hiroaki Aoki, Takehiko Fukami, Atsushi Tajima, Kei Miyakoshi, Katsufumi Otsuki, Norio Shinozuka, Yoshio Matsuda, Mitsutoshi Iwashita, Takashi Okai, Akihito Nakai

Research output: Contribution to journalArticle

Abstract

Objective: To clarify whether distinguishing between the uterine isthmus and cervix can improve the accuracy of diagnosing placenta previa at term. Methods: A multicenter prospective observational study was conducted among pregnant women with suspected placenta previa at 20-24 weeks' gestation. Subjects were divided into the open isthmus group and closed isthmus group. The accuracy of diagnosing placenta previa at term was compared between the 2 groups. Results: We screened 9,341 patients, and 53 (0.6%) met the inclusion criteria. Nineteen cases with an open isthmus and 34 with a closed isthmus were followed. The accuracy for diagnosing placenta previa or a low-lying placenta at term was 94.7% in the open isthmus group and 26.5% in the closed isthmus group (p < 0.001). Elective or emergency Cesarean section was required in 100% of cases in the open isthmus group and 20.6% in the closed isthmus group (p < 0.001). Conclusion: A high prediction rate of placenta previa was obtained by using transvaginal ultrasound at 20-24 weeks' gestation after the isthmus opened by carefully distinguishing between the cervix and isthmus.

Original languageEnglish
Pages (from-to)145-151
Number of pages7
JournalFetal Diagnosis and Therapy
Volume41
Issue number2
DOIs
Publication statusPublished - 2017 Mar 1

Keywords

  • Low-lying placenta
  • Placenta migration
  • Placenta previa
  • Ultrasound
  • Uterine cervix
  • Uterine isthmus

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Embryology
  • Radiology Nuclear Medicine and imaging
  • Obstetrics and Gynaecology

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  • Cite this

    Hasegawa, J., Kawabata, I., Takeda, Y., Aoki, H., Fukami, T., Tajima, A., Miyakoshi, K., Otsuki, K., Shinozuka, N., Matsuda, Y., Iwashita, M., Okai, T., & Nakai, A. (2017). Improving the Accuracy of Diagnosing Placenta Previa on Transvaginal Ultrasound by Distinguishing between the Uterine Isthmus and Cervix: A Prospective Multicenter Observational Study. Fetal Diagnosis and Therapy, 41(2), 145-151. https://doi.org/10.1159/000446212