The diagnostic accuracy of ultrasound in the prediction of placenta accreta spectrum (PAS) | ||
| The Egyptian Journal of Fertility and Sterility | ||
| Article 5, Volume 26, Issue 2, May 2022, Pages 29-39 PDF (2.43 M) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/egyfs.2022.237725 | ||
| Author | ||
| Marwa Mohamed Eid | ||
| Assistant Professor of Obstetrics and Gynecology (Faculty of Medicine-Cairo University) | ||
| Abstract | ||
| Abstract Objective: To evaluate the ability of each sonographic parameter in the prediction of PAS and to correlate this ultrasound assessment to operative judgement of an experienced accreta team and to histopathology of the specimen in cases who were indicated for hysterectomy. Materials and Methods: A total of 60 patients diagnosed as having placenta previa with high possibility of placenta accreta, PAS was diagnosed by the presence of at least one of the following features in color Doppler scan: diffuse or focal lacunar flow, sonolucent vascular lakes and hypervascularity of the utero-vesical interface with bridging vessels connecting the placenta to the bladder. The sonographic provisional diagnosis of accreta was documented. An experienced accrete team who were blinded for the ultrasound result made an intraoperative judgment and classified the case to either (mostly accreta) or mostly (non accreta). Histopathological examination was done to assess the presence of placental invasion & to confirm the diagnosis of placenta accreta for the specimens who required hysterectomy by a pathologist who were also blinded for the ultrasound diagnosis, Results: Placental invasion was found in 35(58.3%) by ultrasound examination of placenta previa cases. Intraoperatively, 36 (60%) patients were assessed to have morbidly adherent placenta (MAP). By histopathological examination 16 cases (45.7 %) were confirmed as placenta accreta and 19 cases (54.3 %) were confirmed as placenta increta .Out of the different ultrasound parameters abnormal lacunae was found to have the highest sensitivity, specificity, PPV, NPV and accuracy in its relation to both intraoperative assessment and histopathological analysis. Conclusion: prenatal ultrasound is the best screening tool for PAS and presence of abnormal lacunae and loss of retro-placental clear zone are accurate predictors for the operative findings and histopathological diagnosis. | ||
| Keywords | ||
| Keywords: Placenta accreta; ultrasonography; Diagnosis; operative findings | ||
|
Statistics Article View: 201 PDF Download: 337 |
||
