TITLE:
Evaluation of Different Ultrasonographic Modalities in the Diagnosis of Morbidly Adherent Placenta: A Cross-Sectional Study
AUTHORS:
Mostafa Hussein, Mohammed F. Ramadan Abd, Ahmad M. Abu-Elhassan, Ahmed M. Abbas, Alaa Eldin A. Youssef
KEYWORDS:
Color Doppler, 3D-Power Doppler, Placenta Accreta, Morbidly Adherent Placenta
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.9 No.4,
April
1,
2019
ABSTRACT: Objective: To compare the accuracy of different ultrasonographic modalities;
two-dimensional ultrasound (2D-US), color Doppler and three-dimensional power
Doppler (3D-PD) in the antenatal diagnosis of the morbidly adherent placenta. Setting: Obstetrics and Gynecology Department, Faculty of Medicine, Assiut
University, Assiut, Egypt. Study Design: A cross-sectional study. Methods: All patients fulfill the inclusions criteria:
gestational age > 28 weeks, previous one or more cesarean delivery, previous uterine surgery, placenta
previa, vitally stable patient and women accepted to participate in the study were included. All patients were evaluated using 2D-US, color
Doppler and 3D-PD before delivery. The final diagnosis was established by
laparotomy and by histopathology of hysterectomy sample if hysterectomy would
be done. Results: One-hundred fifty patients were enrolled in the study. 2D-US has higher
sensitivity (86.96%) than 2D color Doppler (84.06%) and 3D-PD (79.71%) in the
diagnosis of placenta accreta. On the other hand, 3D-PD has slightly higher
specificity (83.95%) than color Doppler (82.72%) and 2D-US (77.78%) in the
diagnosis of placenta accreta. The most sensitive parameter in 2D-Us was the
loss of retroplacental sonolucent zone (86.96%). As regards color Doppler, the
most sensitive parameter was the hypervascularity of the uterine-bladder interface (84.06%). Tortuous vascularity
with chaotic branching was the most
sensitive parameter in 3D-PD with a sensitivity of 82.61%. Conclusions: The use of 3D power Doppler with both 2D-US and color Doppler as
complementary techniques could improve the antenatal diagnosis or exclusion of
morbidly adherent placenta.