PPAP = placenta previa adherent placenta
Patient selection: pregnant woman with placenta previa, between 28 and 32 weeks of gestation
Parameters:
(1) number of previous cesarean sections
(2) number of previous surgical abortions
(3) other uterine surgeries
(4) grade of placental lacunae on ultrasound (from 0 to 3)
(5) loss of clear zone (uteroplacental) on ultrasound
(6) turbulent blood flow on ultrasound
(7) irregular sign (irregularity of the border between the placenta and myometrium around the internal uterina os) on ultrasound
(8) adherent placenta suspected on MRI
|
Parameter
|
Finding
|
Points
|
|
number of previous cesarean sections
|
0
|
0
|
|
|
1
|
2
|
|
|
>= 2
|
4
|
|
number of previous surgical abortions
|
< 3
|
0
|
|
|
>= 3
|
2
|
|
other uterine surgery
|
no
|
0
|
|
|
yes
|
2
|
|
|
yes and placenta at uterine scar
|
4
|
|
grade of placental lacunae
|
0
|
0
|
|
|
1
|
2
|
|
|
>= 2
|
4
|
|
loss of clear zone
|
no
|
0
|
|
|
equivocal
|
2
|
|
|
yes
|
4
|
|
turbulent blood flow
|
no
|
0
|
|
|
equivocal
|
1
|
|
|
present
|
2
|
|
irregular sign on ultrasound
|
no
|
0
|
|
|
yes
|
2
|
|
adherent placenta suspected
|
no
|
0
|
|
|
yes
|
2
|
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 24
• A score >= 8 indicates a significant risk of adherent placenta.
