Gynecology & Obstetrics Department, Medical Faculty, Urmia University of Medical Sciences, Urmia, Iran.
Radiology Department, Medical Faculty, Urmia University of Medical Sciences, Urmia, Iran.
Aims: Morbidly adherent placenta/Placenta accreta syndrome refers to morbid implantation, invasion, and/or adhesion of a placenta, whose incidence rate has increased due to the growing trend of cesarean section. Diagnosing placenta accreta before delivery plays a crucial role in reducing morbidity and mortality of the mother and fetus. This study aimed at evaluating the diagnostic value of the Doppler ultrasonography in diagnosis of morbidly adherent placenta.
Instruments and Methods: In this descriptive-analytical study, 150 singleton pregnant women with gestational age of ≥24 weeks with a history of uterine incision (C/S, myomectomy, or metroplasty), underwent a Doppler ultrasonography to detect the position of placenta and evidence for adherent placenta. The data were analyzed by SPPS 21 software.
Findings: Twelve patients underwent the cesarean-hysterectomy during their cesarean sections due to severe bleeding and morbidly adherent placenta. In terms of pathologic findings, placenta accreta, placenta increta, and placenta percreta were reported in 7 cases, 3 cases, and 1 case, respectively. The Doppler ultrasonography had a sensitivity of 91.67%, a specificity of 100%, a positive predictive value of 100%, and a negative predictive value of 99.28% in the diagnosis of morbidly adherent placenta.
Conclusion: The thinning or absence of the retroplacental myometrial thickness and the large retroplacental lacunae are the most powerful ultrasonographic markers in the diagnosis of the placenta accreta such that the negativity of these markers can be interpreted as the absence of placenta accreta and the positivity of them can be interpreted as the presence of the placenta accreta.
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