PDF icon Download PDF
Am J Perinatol
DOI: 10.1055/a-2572-1646
SMFM Fellowship Series Article

Predictive Capacity of First-Trimester Diagnosis of Placenta Previa

Minhazur Sarker 
1   Department of Obstetrics, Gynecology and Reproductive Science, University of California San Diego, San Diego, California
,
Rachel Feiner
2   School of Medicine, University of California San Diego, La Jolla, California
,
Dana Canfield
1   Department of Obstetrics, Gynecology and Reproductive Science, University of California San Diego, San Diego, California
,
Madison Kent
1   Department of Obstetrics, Gynecology and Reproductive Science, University of California San Diego, San Diego, California
,
Rachel Wiley
1   Department of Obstetrics, Gynecology and Reproductive Science, University of California San Diego, San Diego, California
,
Leah Lamale-Smith
1   Department of Obstetrics, Gynecology and Reproductive Science, University of California San Diego, San Diego, California
,
Elizabeth N. Teal
1   Department of Obstetrics, Gynecology and Reproductive Science, University of California San Diego, San Diego, California
› Author Affiliations
Funding M.S. was supported by a training grant from the National Institute of Child Health and Development (NICHD; T32 HD007203–42). E.N.T. was supported by a mentored career development award from the NICHD (K12 HD001259–24).
› Further Information
Also available ateRefHebammen
   Permissions and Reprints
Preview

Abstract

Objective

First-trimester transabdominal ultrasound (TAUS) is sometimes used to diagnose placenta previa and counsel patients accordingly. We aimed to determine the predictive capacity of a first-trimester transabdominal ultrasonographic placenta previa diagnosis for persistence to the second trimester.

Study Design

Retrospective cohort study of patients with singleton pregnancies and first-trimester transabdominal ultrasonographic placenta previa diagnoses from January to December 2022. The primary outcome was the predictive capacity of a first-trimester TAUS diagnosis of placenta previa for placenta previa persistence into the second trimester. Secondary outcomes included the predictive capacity of a first-trimester TAUS for placenta previa persistence to delivery and risk factors associated with placenta previa persistence. Chi-square and student's t-test were used to determine statistical significance, and a multivariable logistic regression determined the strength of associations.

Results

Of the 185 patients with a first-trimester TAUS diagnosis of placenta previa, 159 (86.0%) resolved by the second-trimester resulting in a predictive capacity for persistence to the second-trimester of 14.0%. Moreover, 182 (98.4%) were resolved by delivery, resulting in a predictive capacity for persistence to delivery of 1.6%. Among the 27 patients with a prior cesarean delivery, the predictive capacity of a first-trimester placenta previa diagnosis for persistence to the second-trimester was 22.2% and to delivery was 7.4%. Advanced maternal age and posterior placenta in the first trimester were risk factors for previa persistence to the second trimester, while prior cesarean delivery and reproductive assistance were not.

Conclusion

First-trimester transabdominal ultrasonographic placenta previa diagnosis has a poor predictive capacity for placenta previa persistence to the second trimester and even lower for persistence to delivery. Counseling patients regarding placenta previa diagnosis in the first trimester may result in unnecessary patient anxiety and activity restrictions.

Key Points

  • First-trimester transabdominal placenta previa diagnosis has poor predictive capacity.

  • Counseling regarding first-trimester placenta previa may result in unnecessary patient anxiety.

  • Studies are needed to see whether patients prefer placenta previa disclosure in the first trimester.

Keywords

first-trimester ultrasound - transabdominal ultrasound - placenta previa - prenatal diagnosis


Publication History

Received: 08 November 2024

Accepted: 02 April 2025

Accepted Manuscript online:
02 April 2025

Article published online:
22 April 2025

© 2025. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA