Abstract
Morbidly adherent placenta a spectrum of condition characterized by invasion of placenta to implantation site. Antenatal diagnosis of placenta accrete spectrum (PAS) is highly desirable because fetomaternal out comes can be optimized. Diagnosis of PAS are accomplished with Doppler ultrasound. It has shown to reduce the burden of fetomaternal morbidity and mortality. The purpose of current study was to check the diagnostic accuracy of Doppler ultrasound in detection of PAS while carefully eliminating bias by controlling confounders we aimed to check the accuracy of Doppler ultrasound in detection of PAS. A cross sectional validation survey was done to find out the diagnostic accuracy of Doppler ultrasound in detection of PAS. The mean maternal age was 28.23±4.31 years. And Mean gestational age was found to be 34.3±1.82 weeks. The mean married age was 3.52±2.39 years. Parity of patients were found to be between 1-15 years with mean parity of 1.6±0.92. Out of 145 patients 3D Doppler ultrasound showed 94 positive cases while per operative findings (Gold standard) showed 90 positive cases. Sensitivity rate was found to be 86.5%, specificity was 90.24%, positive predictive value (PPV) 95.7% and negative predictive value (NPV) 72.5% and diagnostic accuracy of 87.6%.
Highlights
Adherent placenta is a condition in which all or part of placenta is adherent to uterine wall because of myometrial invasion [1]
Placental accrete Spectrum (PAS) are commonly together with placenta previa is due to uterine damage poor handling allow the placenta to grow with absent Nitabuch Layer in myomectomy [4, 5]
Placenta accrete system is an obstetric complication that is potentially ominous for the mother and that is currently developing the characteristics of an epidemic
Summary
Adherent placenta is a condition in which all or part of placenta is adherent to uterine wall because of myometrial invasion [1]. Placental accrete Spectrum (PAS) are commonly together with placenta previa is due to uterine damage (due to previous surgery, cesarean deliveries, curettage, myomectomy) poor handling allow the placenta to grow with absent Nitabuch Layer in myomectomy [4, 5]. Gielchnisky et al (2002) found the risk factors associated with PAS were cesarean section, advance maternal age, high gravidity, multiparity previous curettage, and placenta previa. Repeated cesarean section high parity and anterior low lying placental location were associated with severe outcomes in case of PAS [6]
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