Resolution of a low-lying placenta and placenta previa diagnosed at the midtrimester anatomy scan

Jennifer K. Durst, Methodius G. Tuuli, Lorene A. Temming, Owen Hamilton, Jeffrey M. Dicke

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

Objectives—To identify the incidence and resolution rates of a low-lying placenta or placenta previa and to assess the optimal time to perform follow-up ultrasonography (US) to assess for resolution. Methods—We conducted a retrospective cohort study of women with a diagnosis of a low-lying placenta or placenta previa at routine anatomic screening. Follow-up US examinations were reviewed to estimate the proportion of women who had resolution. A Kaplan-Meier survival curve was generated to estimate the median time to resolution. The distance of the placental edge from the internal cervical os was used to categorize the placenta as previa or low-lying (0.1–10 or≥10–20 mm). A timeto- event analysis was used to estimate predictive factors and the time to resolution by distance from the os. Results—A total of 1663 (8.7%) women had a diagnosis of a low-lying placenta or placenta previa. The cumulative resolution for women who completed 1 or more additional US examinations was 91.9% (95% confidence interval, 90.2%-93.3%). The median time to resolution was 10 (interquartile range [IQR], 7–13) weeks. The distance from the internal cervical os was known for 658 (51.0%) women. The probability of resolution was inversely proportional to the distance from the internal os: 99.5% (≥10–20 mm), 95.4% (0.1–10 mm), and 72.3% (placenta previa; P<.001). The median times to resolution were 9 (IQR, 7–12) weeks for 10 to 20mm, 10 (IQR, 7–13) weeks for 0.1 to 10mm, and 12 (IQR, 9–15) weeks for placenta previa (P=.0003, log rank test). Conclusions—A low-lying placenta or placenta previa diagnosed at the midtrimester anatomy survey resolves in most patients. Resolution is near universal in patients with an initial distance from the internal os of 10mm or greater.

Original languageEnglish
Pages (from-to)2011-2019
Number of pages9
JournalJournal of Ultrasound in Medicine
Volume37
Issue number8
DOIs
StatePublished - Jan 1 2018

Keywords

  • Low-lying placenta
  • Obstetrics
  • Placenta previa
  • Transvaginal ultrasonography for placenta location

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