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Value of the Uterine Artery Color Doppler Study in Detection of Placenta Accreta

Background: Placenta accreta is serious pregnancy complication associated with various maternal morbidity and mortality and is currently the major cause of postpartum hysterectomy. Aim of Study: Evaluation of the value of the uterine artery color Doppler ultrasonography in the detection of placenta accrete in pregnant women with previous cesarean section. Patients and Methods: This study was a prospective observational (Cohort) study was done at Al-Zahraa University Hospital (in Obstetric and Gynecology Department) in the period from December 2017 to February 2019. All women were pregnant in a singleton fetus, their gestational age ranged from 28 to 36 weeks, with history of previous cesarean section and all patients presented with anterior low inserted placenta or placenta centralis. The study included sixty pregnant women without risk factors. Patients were recruited from the causality and the antenatal care clinic with suspected placenta previa (anterior low inserted or complete centralis) during the Third trimester of pregnancy which was confirmed by abdominal ultrasound. All the women in this study were subjected to Complete history taking, physical examination, and routine obstetric ultrasound study for detection of the location of the placenta after the 28 th week of gestation and Color Doppler ultrasound study of the uterine artery. The intraoperative findings of each case were compared with the preoperative imaging findings. Results: Placenta accreta was found in 41.7% of the studied women. The study reported that the mean RI determined by color Doppler ultrasonography of the uterine artery was significantly low in placenta previa with accreta. As it was 0.656±0.190 for placenta without accreta and 0.557 ±0.127 for placenta accreta (p<0.001). The cutoff value of mean uterine artery Doppler PI for placenta accrete obtained from ROCK curve was ≤ 0.93, AUROC (0.636), SN (64%), SP (74.3%), PPV (64%), NPV (71.3%), accuracy (70%) and CI (95%). Conclusion: This study concluded that ultrasound and uterine artery Doppler had a role in detection of placenta accreta in cases with previous CS. The mean uterine artery RI was significantly lower in the placenta accreta compared to placenta previa without accreta. Correspondence to: Dr. Mona Al Sayed Elkafrawy E-Mail: drsaad53@yahoo.com