{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T20:31:14Z","timestamp":1792873874971,"version":"4.5.0"},"reference-count":26,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2015,12,11]],"date-time":"2015-12-11T00:00:00Z","timestamp":1449792000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Ultrasound Medicine"],"published-print":{"date-parts":[[2016,2]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>The purpose of this study was to evaluate the association between first\u2010trimester sonographic findings and morbidly adherent placenta at delivery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a retrospective review of all first\u2010trimester sonographic examinations from pregnancies that underwent third\u2010trimester sonography for placenta previa or low\u2010lying placenta between September 1997 and October 2011. Only women with a prior cesarean delivery were included. Transabdominal and transvaginal images from these first\u2010trimester studies were reviewed for the following sonographic parameters: distance from the inferior border of the gestational sac to the external cervical os, location of the decidua basalis, presence of anechoic areas, uterine\u2010bladder interface irregularity, and smallest anterior myometrial thickness. Morbidly adherent placentation was confirmed on histologic examination of hysterectomy specimens. Statistical methods included univariate and multivariate analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty\u2010nine patients met inclusion criteria, of whom 14 (36%) had confirmed placental invasion. The number of prior cesarean deliveries was significantly associated with placental invasion (<jats:italic>P<\/jats:italic> &lt; .0001). The only first\u2010trimester sonographic finding associated with invasion was the smallest anterior myometrial thickness measured in the sagittal plane (<jats:italic>P<\/jats:italic>&lt; .02). Multivariate analysis based on these two variables yielded an area under the receiver operating characteristic curve of 0.94 (95% confidence interval, 0.87\u20131.00) and significantly improved the prediction of placental invasion compared to using the number of prior cesarean deliveries alone.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In women with persistent placenta previa or low\u2010lying placenta and prior cesarean delivery, the smallest anterior myometrial thickness on first\u2010trimester sonography significantly improved detection of morbidly adherent placenta.<\/jats:p><\/jats:sec>","DOI":"10.7863\/ultra.15.03020","type":"journal-article","created":{"date-parts":[[2016,1,21]],"date-time":"2016-01-21T20:57:31Z","timestamp":1453409851000},"page":"263-269","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":45,"title":["Sonographic Findings of Morbidly Adherent Placenta in the First Trimester"],"prefix":"10.1002","volume":"35","author":[{"given":"Martha W. 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