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E u r o p e a n C o n g r e s s o n
Vaccines & Vaccination
and Gynecologic Oncology
Vaccines & Vaccination and Gynecologic Oncology 2018
O c t o b e r 2 6 - 2 7 , 2 0 1 8
B u d a p e s t , H u n g a r y
Critical Care Obstetrics and Gynecology
ISSN: 2471-9803
Biography
Jeni Panaiotova has graduated in medicine and took speciality
in Obstetrics and Gynecology in Medical University, Sofia,
Bulgaria. During the years, the passion in Fetal medicine,
that was rising in her, made her to apply and finish training in
Fetal Medicine at Fetal Medicine Foundation, London, United
Kingdom. Being part of the FMF team for nearly 4 years and
observing how most of the diseases could be predicted as
early as first trimester of pregnancy, she and her team decided
to start a research of predicting placenta accreta in the first
trimester. The aim of their research was to improve the work
of obstetricians, dealing with this serious and life threatening
obstetric condition, which incidence is rising due to the rising
incidence of delivery by Cesarean section worldwide. After four
years of hardwork, they completed their research and according
to the results, they were able to predict placenta accreta. At the
present moment, she is working in Nadezhda Women’s Health
Hospital, Sofia, Bulgaria, as a Consultant in Fetal medicine and
Obstetrics.
jeni_panaiotova@yahoo.comScreening for morbid adherent placenta (MAP) in early pregnancy
Jeni Panaiotova, Mayumi Tokunaka, Karolina Krajewska, Nurit
Zosmer and Kypros H Nicolaides
Harris Birthright Research Centre, UK
Objective:
To estimate the diagnostic accuracy of a two-stage strategy for early
prediction of morbid adherent placenta (MAP). In the first stage, at 11-13 weeks’
gestation women with history of previous uterine surgery and low lying placenta
are classified as being at high-risk for MAP and in the second stage, at 12-16
weeks, these high-risk pregnancies are assessed at a specialist MAP clinic.
Methods:
This was a prospective study in women having an ultrasound scan at
11-13 weeks’ gestation as a part of routine pregnancy care. Women with a history
of previous uterine surgery and low lying placenta were followed up in a specialist
MAP clinic, at 12-16 weeks’ gestation, 20-24 weeks and 28-34 weeks. In each visit
to the MAP clinic an ultrasound scan was carried out and the following features
suggestive of MAP were recorded: non-visible cesarean section scar, bladder wall
interruption, thin retroplacental myometrial thickness, presence of intraplacental
lacunar spaces, presence of retroplacental arterial-trophoblastic blood flow and
irregular placental vascularization demonstrated by 3D Power Doppler.
Results:
Screeningat 11-13weekswascarried in22,604singletonpregnanciesand
1,298 (6%) were considered to be at high-risk of MAP because they had previous
uterine surgery and low lying placenta. In the MAP clinic at 12-16 weeks, the
diagnosis of MAP was suspected in 14 cases and this was confirmed at delivery
in 13. In the rest of the population there were no cases of MAP.
Conclusion:
AccuratepredictionofMAPcanbeachievedbyultrasoundexamination
at 12-16 weeks gestation.
Jeni Panaiotova et al., Crit Care Obst & Gyne 2018, Volume: 4
DOI:10.21767/2471-9803-C1-002