mvjrМедицинский вестник Юга РоссииMedical Herald of the South of Russia2219-80752618-7876The Rostov State Medical University10.21886/2219-8075-2022-13-4-58-65mvjr-1580Research ArticleАКУШЕРСТВО И ГИНЕКОЛОГИЯOBSTETRICS AND GYNECOLOGYPlacenta accreta spectrum. Актуальные вопросы диагностикиPlacenta accreta spectrum. Current diagnostic issueshttps://orcid.org/0000-0002-5899-1252ВолковА. Е.VolkovA. E.

Волков Андрей Евгеньевич - кандидат медицинских наук, доцент, доцент кафедры акушерства и гинекологии №1.

Ростов-на-Дону

Andrey E. Volkov - Cand. Sci. (Med.), Associate Professor, Department of Obstetrics and Gynecology №1, Rostov State Medical University.

Rostov-on-Don

avolkov@aaanet.ruРымашевскийМ. А.RymashevskiyM. A.

Рымашевский Михаил Александрович – кандидат медицинских наук, ассистент кафедры акушерства и гинекологии №1.

Ростов-на-Дону

Mikhail A. Rymashevskiy - Cand. Sci. (Med.), assistant of the Department of Obstetrics and Gynecology, Rostov State Medical University.

Rostov-on-Don

АндрусенкоИ. В.AndrusenkoI. V.

Андрусенко Ирина Валерьевна - заместитель главного врача, врач высшей категории.

Ставрополь

Irina V. Andrusenko - Deputy Chief Physician, Doctor of the highest category, Nadezhda Medical Center.

Stavropol

irvalan@yandex.ruРостовский государственный медицинский университетРоссияRostov State Medical UniversityRussian FederationМедицинский Центр «Надежда»РоссияMedical Center «Nadezhda»Russian Federation2022010120231345865Copyright © Волков А.Е., Рымашевский М.А., Андрусенко И.В., 20232023Волков А.Е., Рымашевский М.А., Андрусенко И.В.Volkov A.E., Rymashevskiy M.A., Andrusenko I.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.medicalherald.ru/jour/article/view/1580

В настоящем обзоре литературы рассмотрены вопросы диагностики аномального прикрепления (врастания) плаценты (PAS) (ультразвукового сканирования (УЗИ), магнитно-резонансной томографии (МРТ), изучение сывороточных маркеров аномалии). Системный поиск литературы проводился по базам данных PudMed, Scopus и др. Обсуждены вопросы эволюции взглядов на причины данной аномалии и её классификации. Отмечено, что настоящее время основным методом диагностики врастания плаценты является УЗИ. Рекомендовано двухмерное серошкальное сканирование в комплексе с цветовым допплеровским картированием (ЦДК) и трёхмерной эхографии с опцией энергетического допплера. Однако эхография остаётся абсолютно «оператор-зависимым» методом, следовательно, в значительной мере субъективным, определяемым опытом специалиста в выявлении данной патологии инструментом. МРТ рекомендована в качестве инструмента для оценки глубины инвазии при подозрении на placenta percreta и в диагностике сложных случаев (предлежащей плаценты по задней стенке матки). УЗИ и МРТ обладают весьма высоким диагностическим потенциалом. Принято считать, что УЗИ является недорогим, широкодоступным методом визуализации, рекомендовано в качестве первоочередного в диагностике PAS. МРТ не играет первоочередной роли в диагностике PAS, но может быть незаменимой для детализации топографии областей, которые сложно оценить при УЗИ.

In this review of the literature, the issues of diagnosis of abnormal attachment (ingrowth) of the placenta (PAS) are considered: ultrasound scanning (ultrasound), magnetic resonance imaging (MRI), the study of serum markers of the anomaly. A systematic literature search was conducted on the databases PudMed, Scopus and others. The issues of the evolution of views on the causes of this anomaly and its classifications are also discussed. It is noted that currently the main method of diagnosis of placenta accreta is ultrasound. Two-dimensional grayscale scanning in combination with color Doppler mapping (CDK) and three-dimensional echography with the option of energy Doppler is recommended. However, echography remains an absolutely "operator dependent" method, therefore, largely subjective, determined by the experience of a specialist in detecting this pathology with an instrument. MRI is recommended as a tool for assessing the depth of invasion in case of suspected placenta percreta and in the diagnosis of complex cases (placenta previa along the posterior wall of the uterus). Ultrasound and MRI have a very high diagnostic potential. It is generally considered that ultrasound is an inexpensive, widely available imaging method, recommended as a priority in the diagnosis of PAS. MRI does not play a primary role in the diagnosis of PAS, but it can be indispensable for detailing the topography of areas that are difficult to assess with ultrasound.

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The authors declare that there are no conflicts of interest present.