Gestação normal
O rastreamento para placenta prévia (PP) não é indicado nessa população, mesmo se outros fatores de risco estiverem presentes (com exceção de cicatrização uterina prévia, PP prévia e tratamento de fertilização in vitro [FIV]). Modelos de predição combinando os fatores de risco para PP são excessivamente ineficientes para ser úteis.[9]Odibo AO, Cahill AG, Stamilio DM, et al. Predicting placental abruption and previa in women with a previous cesarean delivery. Am J Perinatol. 2007 May;24(5):299-305.
http://www.ncbi.nlm.nih.gov/pubmed/17514600?tool=bestpractice.com
Útero cicatrizado previamente
Rastreamento por ultrassonografia com encaminhamento para ultrassonografia com dopplerfluxometria em caso de suspeita de PP.[2]Royal College of Obstetricians and Gynaecologists. Placenta praevia and placenta accreta: diagnosis and management. Green-top guideline no. 27a. Sep 2018 [internet publication].
https://www.rcog.org.uk/en/guidelines-research-services/guidelines/gtg27a
[3]Reddy UM, Abuhamad AZ, Levine D, et al. Fetal imaging: executive summary of a joint Eunice Kennedy Shriver National Institute of Child Health and Human Development, Society for Maternal-Fetal Medicine, American Institute of Ultrasound in Medicine, American College of Obstetricians and Gynecologists, American College of Radiology, Society for Pediatric Radiology, and Society of Radiologists in Ultrasound Fetal Imaging Workshop. J Ultrasound Med. 2014 May;33(5):745-57.
http://www.ncbi.nlm.nih.gov/pubmed/24764329?tool=bestpractice.com
[4]American College of Obstetricians and Gynecologists / Society for Maternal-Fetal Medicine. ACOG SMFM obstetric care consensus #7: placenta accreta spectrum. Dec 2018 [internet publication].
https://www.acog.org/clinical/clinical-guidance/obstetric-care-consensus/articles/2018/12/placenta-accreta-spectrum
O radiologista deve ser informado sobre o risco do espectro da placenta acreta.[4]American College of Obstetricians and Gynecologists / Society for Maternal-Fetal Medicine. ACOG SMFM obstetric care consensus #7: placenta accreta spectrum. Dec 2018 [internet publication].
https://www.acog.org/clinical/clinical-guidance/obstetric-care-consensus/articles/2018/12/placenta-accreta-spectrum
Deve-se buscar aconselhamento do ultrassonografista ou especialista em obstetrícia quanto à indicação ou não de ressonância nuclear magnética (RNM).[6]Getahun D, Oyelese Y, Salihu HM, et al. Previous cesarean delivery and risks of placenta previa and placental abruption. Obstet Gynecol. 2006 Apr;107(4):771-8.
http://www.ncbi.nlm.nih.gov/pubmed/16582111?tool=bestpractice.com
[9]Odibo AO, Cahill AG, Stamilio DM, et al. Predicting placental abruption and previa in women with a previous cesarean delivery. Am J Perinatol. 2007 May;24(5):299-305.
http://www.ncbi.nlm.nih.gov/pubmed/17514600?tool=bestpractice.com
[10]Qublan HS, Tahat Y. Multiple cesarean section. The impact on maternal and fetal outcome. Saudi Med J. 2006 Feb;27(2):210-4.
http://www.ncbi.nlm.nih.gov/pubmed/16501678?tool=bestpractice.com
[24]Wu S, Kocherginsky M, Hibbard JU. Abnormal placentation: twenty-year analysis. Am J Obstet Gynecol. 2005 May;192(5):1458-61.
http://www.ncbi.nlm.nih.gov/pubmed/15902137?tool=bestpractice.com
[31]Kallen B, Finnstrom O, Nygren KG, et al. In vitro fertilisation in Sweden: obstetric characteristics, maternal morbidity and mortality. BJOG. 2005 Nov;112(11):1529-35.
http://www.ncbi.nlm.nih.gov/pubmed/16225574?tool=bestpractice.com
[32]Shevell T, Malone FD, Vidaver J, et al. Assisted reproductive technology and pregnancy outcome. Obstet Gynecol. 2005 Nov;106(5 Pt 1):1039-45.
http://www.ncbi.nlm.nih.gov/pubmed/16260523?tool=bestpractice.com
Placenta prévia anterior
PP apresenta um risco moderado de recorrência (cerca de 0.7%).[13]Ananth CV, Demissie K, Smulian JC, et al. Placenta previa in singleton and twin births in the United States, 1989 through 1998: a comparison of risk factor profiles and associated conditions. Am J Obstet Gynecol. 2003 Jan;188(1):275-81.
http://www.ncbi.nlm.nih.gov/pubmed/12548229?tool=bestpractice.com
Deve-se prestar atenção à posição da placenta em gestações subsequentes; deve ser realizada uma ultrassonografia na metade do segundo trimestre.
FIV
Gestações resultantes de FIV apresentam cerca de 2% de risco de PP.[33]Reddy UM, Wapner RJ, Rebar RW, et al. Infertility, assisted reproductive technology, and adverse pregnancy outcomes: executive summary of a National Institute of Child Health and Human Development workshop. Obstet Gynecol. 2007 Apr;109(4):967-77.
http://www.ncbi.nlm.nih.gov/pubmed/17400861?tool=bestpractice.com
[34]Mukhopadhaya N, Arulkumaran S. Reproductive outcomes after in-vitro fertilization. Curr Opin Obstet Gynecol. 2007 Apr;19(2):113-9.
http://www.ncbi.nlm.nih.gov/pubmed/17353678?tool=bestpractice.com
[35]Romundstad LB, Romundstad PR, Sunde A, et al. Increased risk of placenta previa in pregnancies following IVF/ICSI; a comparison of ART and non-ART pregnancies in the same mother. Hum Reprod. 2006 Sep;21(9):2353-8.
https://academic.oup.com/humrep/article/21/9/2353/2938873
http://www.ncbi.nlm.nih.gov/pubmed/16728419?tool=bestpractice.com
Indica-se rastreamento por ultrassonografia, aproximadamente entre a 18ª e a 22ª semana de gestação.[33]Reddy UM, Wapner RJ, Rebar RW, et al. Infertility, assisted reproductive technology, and adverse pregnancy outcomes: executive summary of a National Institute of Child Health and Human Development workshop. Obstet Gynecol. 2007 Apr;109(4):967-77.
http://www.ncbi.nlm.nih.gov/pubmed/17400861?tool=bestpractice.com
[34]Mukhopadhaya N, Arulkumaran S. Reproductive outcomes after in-vitro fertilization. Curr Opin Obstet Gynecol. 2007 Apr;19(2):113-9.
http://www.ncbi.nlm.nih.gov/pubmed/17353678?tool=bestpractice.com
[35]Romundstad LB, Romundstad PR, Sunde A, et al. Increased risk of placenta previa in pregnancies following IVF/ICSI; a comparison of ART and non-ART pregnancies in the same mother. Hum Reprod. 2006 Sep;21(9):2353-8.
https://academic.oup.com/humrep/article/21/9/2353/2938873
http://www.ncbi.nlm.nih.gov/pubmed/16728419?tool=bestpractice.com