Accuracy of the three-dimensional 3D Doppler over conventional 2D ultrasound in the diagnosis of morbid adherent placenta (MAP)

Abstract

Background: Two-dimensional ultrasound [2D] is in routine use in nearly most of the hospitals and many physician clinics as it offers a lot of benefits compared to other medical imaging techniques. Ultrasonography offers unique qualities including real-time imaging, physiologic measurement, use of non-ionizing radiation and no known bio-effects in the diagnostic range, while being non-invasive. Sonographic image quality has increasingly benefited from sophisticated computer technology.Aim of the Work: Is to evaluate the diagnostic accuracy of three-dimensional (3D) power Doppler over conventional 2D Doppler in diagnosis of morbidly adherent placenta in patients with one or more previous cesarean section diagnosed as placenta previa.Patients and Methods: The present study was carried out at Ain-Shams University Maternity Hospital. Women approached were recruited from Special Care Center of the fetus. After proper counseling, all women who were chosen for enrollment agreed to participate. The total number of pregnant women enrolled in the study was 120 women.Results: In the following analysis, intraoperative and placental histopathology findings were considered as golden standard test when compared to the 2D and 3D uterine ultrasonography amongst the 120 studied cases.Conclusion: The current study suggested that 3D power Doppler modality had a better screening capability for the prediction of the sequel of morbid placentation; namely, difficult placental delivery, considerable intraoperative blood loss, need for caesarean hysterectomy and bladder injury in women with placenta previa prior to cesarean (by its higher sensitivity and negative predictive value (NPV) and its lower false negative rates) when compared to the 2D ultrasound