Diagnostic Value of Doppler Ultrasonography in the Diagnosis of Morbidly Adherent Placenta

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 theGrowing trend of cesarean section. Diagnosing placenta accreta before delivery plays aCrucial role in reducing morbidity and mortality of the mother and fetus. This study aimedat evaluating the diagnostic value of the Doppler ultrasonography in diagnosis of morbidlyAdherent placenta.Instruments and Methods: In this descriptive-analytical study, 150 singletons pregnantWomen 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 cesareansections due to severe bleeding and morbidly adherent placenta. In terms of pathologicfindings, 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 of99.28% 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