Antepartum Evaluation of Placenta Accreta in Women with Placenta Previa by Color Doppler, Power Doppler Ultrasound and MRI: A Prospective Study

Abstract Background: Complications of placenta accreta include massive hemorrhage, damage to the uterus, bladder, ureters, and bowel, and often cesarean hysterectomy to control bleed-ing. Prenatal diagnosis of placenta accreta can help minimize the complication rate by enabling a surgeon to plan for the type of resources needed at the time of delivery. Aim of Study: The aim of the study is to study the role of color Doppler, power Doppler ultrasound and MRI in diagnosis of placenta accreta and the accuracy of each method in diag-nosis of the level of accretion. Material and Methods: Fifty women with criteria of have low lying placenta or placenta previa, have at least one previous uterine scar, have mild or no vaginal bleeding underwent color Doppler ultrasound, power Doppler ultrasound and MRI study at 34-36 weeks gestation. The result of degree of accretion compared for each radiological method by that found intraoperative. Results: Fifty pregnant women were included in this study, with a mean age 31.18±3.88. All patients proved by US to have placenta previa. Thirty two patients were diagnosed to be placenta accreta by color & power Doppler U/S, while 31 patient of the case were diagnosed to have placenta accreta by MRI. According to the pre-operative color & power Doppler and MRI findings and the intra-operative findings, color and power Doppler US has 96.4% sensitivity of in diagnosis of placenta accreta, while MRI has 82.1% sensitivity and com-bination of both imaging technique has the lowest sensitivity 78.6% but this combination has the highest specificity 90.9%, while MRI has the lowest specificity 63.6%. Conclusion: Color and power Doppler abdominal U/S are more sensitive in diagnosis of placenta accreta (96.4%) than MRI (82.1%). The combination of color and power Doppler U/S and MRI has the highest specificity (90.9%).