ACCURACY OF MULTI-SLICE 3D-DOPPLER IN DIAGNOSIS OF MORBIDLY ADHERENT PLACENTA IN COMPARISON WITH 2D-DOPPLER

Abstract

Background: Morbidly adherent placenta can be diagnosed prenatally by different modalities. 2D, 3D multi-slice Doppler ultrasound and MRI have emerging roles in prenatal diagnosis of morbidly adherent placenta, but histopathological diagnosis is the gold standard.Aim of the work: To detect the accuracy of multi-slice 3D Doppler ultrasound over 2D-Doppler in diagnosis of placenta accreta in relation to postpartum histopathology and intrapartum findings.Patients and Methods: This study was conducted at Ain shams university maternity hospital during the period between March 2020 and September 2020. A total of 50 pregnant women having placenta Previa were included in the study. Patients were included in the study according to the following criteria: Pregnant women with history of previous cesarean section or hysterotomy, placenta previa with its lower edge covering the scar of previous cesarean section, From 28 wks – Full term.Each patient was scanned in a systematic fashion by 2D ultrasonography, 2D-Doppler, Multislice 3D-Doppler preoperatively and results were compared with histopathological examination postoperatively.Results: Crowded vessels over peripheral sub-placental zone had the highest diagnostic characteristics among multislice 3D Doppler signs in diagnosis of placental invasion compared with postoperative histopathology with (sensitivity 95.2%, specificity 93.1%, PPV 90.9%, NPV96.4%, LR 270.00).Hyper vascularity of serosa–bladder interface had the highest diagnostic characteristics among 2D Doppler ultrasonography signs in the diagnosis of placental invasion compared with postoperative histopathology with (sensitivity 90.5%, specificity 89.7%, PPV 86.4%, NPV 92.9%, LR 82.33).Conclusion: Multi-slice 3D Doppler ultrasound is more accurate than 2D ultrasound in diagnosis of placenta accrete and degree of adherence in relation to postpartum histopathology and intrapartum findings.