Principal Investigator: Bob Silver
Keywords: Placenta Accreta , Accreta Department: Obstetrics And Gynecology (Dept)
IRB Number: 00069530
Specialty: Maternal-Fetal Medicine
Sub Specialties:
Recruitment Status: Enrolling by invitation

Contact Information

Sarah Lopez

Brief Summary

  1. To establish a data, tissue and DNA bank for the purpose of:
  1. Molecular characterization of placenta accreta
  2. Investigation of genetic factors that may alter an individual’s risk for development of accreta
  3. Investigation of potential biochemical markers that may assist in the prenatal diagnosis of placenta accreta
  1. To prospectively observe women with risk factors or antenatal suspicion of placenta accreta to better our understanding of this rare disorder with regard to:
  1. Risk factors for and pathophysiology of invasive placentation
  2. Prenatal diagnostic strategies (imaging and biochemical markers)
  3. Optimal antenatal, perioperative, and postoperative management strategies to minimize maternal and fetal/neonatal morbidity
  1. To assess longterm outcomes and sequelae of placenta accreta and peripartum hysterectomy
  2. To retrospectively review the charts of women with suspected accreta not diagnosed until the time of delivery and approach them for participation in the tissue/DNA bank and longterm outcome portions of the study
  3. To create a database of women with placenta accreta spectrum by histopathological or clinical criteria for ongoing research

Inclusion Criteria

  1. Age 18 years or older
  2. Clinical risk factors for placenta accreta
    1. Placenta previa after 16 weeks gestation with a history of prior cesarean and/or prior uterine surgery
    2. Diagnosed with placenta previa
    3. Anterior low-lying placentation (inferior placental margin ending within 2 cm of the internal cervical os) persisting after 28 weeks gestation with a history of prior cesarean and/or prior uterine surgery
    4. History of placenta accreta in a prior pregnancy
    5. Three or more prior cesareans
    6. Women who undergo peripartum hysterectomy for any reasons
    7. Women with placenta previa >34 weeks without history of prior cesarean
  3. Women with sonographic findings suspicious for placenta accreta
    1. Extensive placental lakes/lacunae
    2. Increased retroplacental vascularity with turbulent flow
    3. Loss of myometrial borders
    4. Protrusion of the placenta into the bladder
  4. Women with documented placenta accreta based on clinical or histopathological criteria around the time of delivery
  5. Cesarean scar pregnancy (CSP), also known as cesarean scar "ectopic", is thought to be a precursor for placenta accreta spectrum.  Patients diagnosed with CSP in the first or second trimester can be considered for enrollment in this study. 

Data and samples collected under the following IRB approved studies will be added to this current study (IRB 69530) in order to create one main data and sample banking study relating to women diagnosed with placenta accrete or persistent placenta previa.  The studies below will be closed upon receiving IRB approval for our current IRB application (Understanding Placenta Accreta: Improving Diagnostic Accuracy, Evaluating Optimal Management Strategies and Assessment of Long-Term Outcomes - IRB#69530).

1.  IRB 37514 - Longterm Outcomes of Women with Placenta Accreta and Establishment of a Tissue Bank (PI: Robert Silver)

2.  IRB 39005 - Clinical and Molecular Characterization of Placenta Accreta: A prospective, observational study to establish a database and tissue bank (PI: Robert Silver)

3.  IRB 51145 - Strategies for Optimal Management of Patients with Placenta Accreta: A Retrospective Review of 15 Years Experience (PI:  Alexandra Grosvenor)


Exclusion Criteria

Under age 18