Gray scale and Doppler ultrasound in placenta accreta: Optimization of ultrasound signs

Aim of workTo optimize ultrasound and Doppler signs in placenta accreta, and to clarify sensitivity and specificity.Patients & methodsThis study included 50 pregnant women. The examinations were done in private center from January 2013 to November 2013. Patients have anterior low lying placenta or anterior placenta previa with history of previous CS. US was done using curvilinear or endovaginal transducer at frequency 3–5 MHz and 3–9 MHz.ResultsThis study included 50 pregnants with mean age of 29.92 y. Placental lacunae, loss of retroplacental space, retroplacental myometrial thickness, echogenic bladder wall (hyperechoic uterine serosato–bladder interface) and Doppler criteria were evaluated. Of 18 cases having placenta accreta, 16 (88.9%) had placental lacunae with Doppler abnormality. P values for the above mentioned US signs were <0.001(HS), 0.006(S), <0.001(HS), 0.019(HS). Placental lacunae were found in 16 of 18 women with placenta accreta with sensitivity of 89%, specificity of 81%, 73% positive predictive value and 93% negative predictive value. Placental lacunae were found in 6 women (18.8%) with no placenta accreta.ConclusionUltrasound and Doppler examinations of placenta have signs highly suggestive of placenta accreta due to high sensitivity and specificity with placental lacunae of turbulent flow and retro-placental myometrial thickness ⩽1 mm are of the highest specificity.