Low Lie Placenta Accreta In Women With Prior Uterine Surgery: Diagnostic Value of Transvaginal Color Doppler Ultrasound and MRI

Farghaly Amin, Mohammed
2012 · doi:10.1594/ecr2012/c-2352 · W6887357344
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Transvaginal color Doppler ultrasound and MRI demonstrated high sensitivity for diagnosing placenta accreta in women with prior uterine surgery, aiding clinical management.

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This study evaluated the diagnostic accuracy of transvaginal color Doppler ultrasound and MRI for prenatal detection of placenta accreta in 28 women with a history of prior uterine surgery. The researchers correlated imaging findings with surgical and pathological results, determining that color Doppler sonography achieved a sensitivity of 90% and an accuracy of 78% in identifying the condition. The authors concluded that both imaging modalities are effective tools for establishing diagnosis or exclusion, which positively impacts peripartum clinical management. This paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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Keywords

MR, Obstetrics (Pregnancy / birth / postnatal period), Technology assessment, Obstetrics, Volvulus Authors: N. F. El Ameen, M. Farghaly Amin; ElMinia/EG DOI: 10.1594/ecr2012/C-2352 Purpose The purpose of this exhibit is to test the value of transvaginal color doppler sonography and MRI findings in prenatal diagnosis of placenta accreta in gravid uterus with prior surgery and correlate the findings with surgical and pathological reports.

Methods

and Materials The study population comprised 28 consecutive gravid women with a history of previous uterine surgery were suspected to had placenta accreta. Inclusion criteria based upon clinical history and abdominal ultrasonography as follow: 1-Abnormal placental position, placenta previa. 2- Suspected placenta accreta (loss of the retroplacental sonolucent zone, irregular retroplacental sonolucent zone, thinning or disruption of hyperechoic serosa–bladder interface and presence of focal exophytic masses invading the urinary bladder. In our study color doppler sonographic criteria for positive diagnosis of PA were diffuse or focal lacunar...

Results

The age of our patients ranged from 23 to 40 years old with mean age 33.2 years. All patientshad past history of uterine surgery, 23/28 (82%) previous Cesarean section. Abnormal placental position was detected in all 100% patients (Low lie in 21/28 (75%), pervia marginalis in 5/28(17.8%), and previa centralis in 2(7%) patients). According to the final surgical and pathological reports, color doppler sonography had sensitivity 90% to predict placenta accreta, specificity 70%, positive predictive value 67%, negative predictive value 92%, accuracy percentage 78%, and...

Conclusion

Color doppler and MRI findings in patients with risk factors for placenta accreta were useful in establishing and prediction of antenatal placenta accreta diagnosis or exclusion with positive impact on the peripartum clinical management and clinical outcome of the affected patients. Sonography and MRI have nearly the same sensitivity for prenatal diagnosis of placenta accreta.

References

Usta IM, Hobeika EM, Musa AA, Gabriel GE,Nassar AH. Placenta previa-accreta: risk factors and complications. Am J Obstet Gynecol 2005;193:1045–1049. Mazouni C, Gorincour G, Juhan V, Bretelle F.Placenta accreta: a review of current advances in prenatal diagnosis. Placenta2007;28(7):599–603. To WW, Leung WCPlacenta previa and previous cesarean section. Int J Gynaecol Obstet1995;51(1):25–31. RM Silver,LandonMB, Rouse DJ. Maternal morbidity associated with multiple repeat cesarean deliveries. Obstet Gynecol 2006;107:1226–1232. Moodley J, NgambuNF, Corr P.Imaging techniques to identify morbidly adherent placenta praevia: a prospective study. J Obstet Gynaecol2004;24(7):742–744. YangJI,LimYK,... Personal Information Nadia El Ameen, MD. Lecturer of Radiology. El Minia university hospital El Minia- Egypt, TN 00201288629024- [email protected]

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