Role of Sonography in Prenatal Evaluation of Placenta Accreta

Abstract

Objective: To evaluate the diagnostic accuracy of gray scale and doppler examination in antenatal diagnosis of placenta accreta. Materials and Methods: This is a prospective study done in a tertiary care center having large number of obstetrical cases,Ziauddin University hospital during a period of ten months from 12th August 2014 to 11th June 2015.Thirty seven pregnant high risk cases all with clinical suspicion of placenta accreta were subjected to sonographic evaluation using gray scale and color doppler imaging by senior radiologists. Presence of vascular lacunae with turbulent flow, loss of retro-placental clear space, vessels traversing the uterine serosa, thin out myometrium and interrupted retro-placental flow was evaluated sonographically. Maternal delivery records were reviewed for delivery outcomes and sonographic findings were confirmed at delivery on surgical and clinical findings. Results: The diagnostic sensitivity of ultrasound for placenta accreta was 93.3% and specificity was 85.7%. Positive predictive value was 96.5% whereas negative predictive value of 75%. Conclusion: Gray scale and color Doppler sonography has fairly good sensitivity for prenatal diagnosis of placenta accreta