Uteroplacental detachment on transvaginal ultrasound is associated with substantial antepartum hemorrhage requiring early delivery in high-risk placenta accreta spectrum cases

American Journal of Obstetrics and Gynecology 2026 Open access

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Authors: Rozi Aditya Aryananda, Theophilus K. Adu-Bredu, Nareswari Imanadha Cininta, Clement Twumasi, Savitree Pranpanus, Conrado Milani Coutinho, Bayu Priangga, Qurrata Akyuni, Heleen J. van Beekhuizen, Albaro Jose Nieto-Calvache, José Miguel Palacios-Jaraquemada, Agus Sulistyono
+5 more Erry Gumilar Dachlan, Manggala Pasca Wardhana, Hasna Sholihah, Christoph C. Lees, Hans Duvekot
DOI: 10.1016/j.ajog.2025.09.051
Cited by: 1
References: 26

Abstract

INTRODUCTION: Accurately predicting progression from mild to substantial antepartum hemorrhage requiring early delivery in patients with a high risk for placenta accreta spectrum remains a clinical challenge, limiting effective monitoring and counseling. This study aims to identify ultrasound features associated with substantial antepartum hemorrhage necessitating early cesarean delivery using a comprehensive imaging protocol. MATERIALS AND METHODS: This was secondary analysis of a prospectively collected data of high-risk placenta accreta spectrum patients between September 2023 and August 2024 in Indonesia. A comprehensive ultrasound protocol combining transabdominal and transvaginal approaches was used to assess various ultrasound signs. Antepartum hemorrhage was classified as >/=500 mL (substantial antepartum hemorrhage) or

Fields of Study & Subjects

Maternal and fetal healthcare Pregnancy and preeclampsia studies Reproductive Health and Contraception

Publication details

Journal / source
American Journal of Obstetrics and Gynecology
Publisher
Elsevier BV
Volume
233
Issue
6
Pages
S701–S710
Publication date
1 January 2026
Language
EN