Thinner Endometrial Thickness Increases Risk of Placenta Accreta Spectrum: Key Insights for Expecting Mothers

Endometrial thickness (EMT) influences the risk of placenta accreta spectrum (PAS) in women without cesarean delivery (CD) history undergoing assisted reproductive technology (ART), according to a study in the American Journal of Obstetrics & Gynecology.

PAS can cause severe maternal health issues, being a major cause of hemorrhage, blood transfusions, and emergency postpartum hysterectomy. Known risk factors for PAS include previous CD, placenta previa, in vitro fertilization (IVF), and maternal age over 35 years.

Early detection of PAS is crucial because it often presents without symptoms. The endometrium, the uterine lining, is essential for embryo implantation, and its thickness may significantly affect pregnancy outcomes. Researchers conducted a retrospective study to assess the link between EMT and PAS in patients undergoing IVF or intracytoplasmic sperm injection (ICSI) at the Third Affiliated Hospital of Guangzhou Medical University from January 2008 to July 2020.

The study involved 4,637 women, of whom 3.4% experienced pregnancies complicated by PAS. The analysis revealed that women with PAS had lower EMT measurements before embryo transfer compared to those without PAS. Other complications, like placenta previa and preeclampsia, were also more common in the PAS group, though overall maternal and neonatal outcomes did not show significant differences.

The study demonstrated a connection between decreased EMT and increased PAS risk, especially below 10.9 mm in thickness. The odds of PAS increased with thinning EMT, highlighting the importance of measuring EMT during ART procedures.

In summary, thinner EMT correlates with a higher risk of PAS in women without CD history. This finding suggests that healthcare providers should consider EMT as a vital factor when planning ART treatments.