Volume 8, Issue 1, January 2020, Page: 12-15
Diagnostic Accuracy of Doppler Ultrasound for Antenatal Detection of Placenta Accreta Spectrum (PAS) Disorders
Sadia Asghar, Department of Obstetrics and Gynecology, Rai Medical College, Sargodha, Pakistan
Nafeesa Naz, Department of Obstetrics and Gynecology, Allied Hospital, Faisalabad, Pakistan
Received: Nov. 19, 2019;       Accepted: Dec. 19, 2019;       Published: Jan. 8, 2020
DOI: 10.11648/j.jgo.20200801.13      View  448      Downloads  255
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%.
Placenta Accrete Spectrum (PAS), Feto Maternal Outcome
To cite this article
Sadia Asghar, Nafeesa Naz, Diagnostic Accuracy of Doppler Ultrasound for Antenatal Detection of Placenta Accreta Spectrum (PAS) Disorders, Journal of Gynecology and Obstetrics. Vol. 8, No. 1, 2020, pp. 12-15. doi: 10.11648/j.jgo.20200801.13
Copyright © 2020 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Kean L. Antepartum haemorrhage. In: Luesly DM, Baker PN, Cardozo L, Drif J, editors. Obstetric and Gynecology evidence based text for MRCOG 1st ed. London: Arnold; 2004. p. 303.
Jauniax E, Chantraine F, Silver RM, Langhoff_Roos J; FIGO placenta Accrta Diagnosis and Management Expert Consensus Panel. FIGO consensus guideline on placen ta accrete spectrum disorder: Epidimiology. Int J Gynaecol Obstet. 2018; 140 (3): 265_73.
Baker PN. Obstetrics by ten teacher 18th ed. 338 london Arnold; 2006.
Wu, S, Kocherginsky M, Hibbarad JU. Abnormal Placental: twenty years analysis. Am J Obstet Gynecol. 2005; 192 (5): 1458_61.
Ananth CV, Svit DA, Luther ER. Maternal cigarette smoking as a risk factor for placental abruption,, Placenta Previa, and uterine bleeding Pregnancy. Am J Epidimiology. 1996; 144 (9): 881_9.
Bahar A, Abusham A, Eskandar M, Sobande A, Alsunaidi M. Risk factors and pregnancy outcome in different types of placenta praevia. J Obstet Gynaecol Can 2009; 31: 126-31.
Warshak CR. EsKander R, Hull AD, Sciosua AL, Mattrey RF, Benirschke Ket al. Accuracy of Ultrasonography and Magnetic resonance imaging in the diagnosis of placenta accrete. Obstet Gynaeccol 2006; 108 (3pt 1): 573_81.
Comstock CH, Love JJ Jr, Bronsteen RA, Lee W, Vettraino IM, Huang RR et al. Sonographic detection of placenta accrete in the second and third trimester of pregnancy. Am J Obstet Gynecol. 2004; 190 (4): 1135_40.
Biswas R, Sawhney H, Dass RS, Sarwan RK, Vasishta K. Histopathological study of placental bed biopsy in placenta praevia. Acta Obstet Gynecol Scand 1999; 78: 173-9.
Robinson BK, Grobman WA. Effectiveness of timing strategies for delivery of individuals with placenta praevia and accreta. Obstet Gynecol 2010; 116: 835-42.
Chou MM, Ke YM, Wu HC, Tsai CP, Ho ES, Ismail H, et al Temporary cross-clamping of the infrarenal abdominal aorta during caesarean hysterectomy to control operative blood loss in placenta praevia increta/percreta. Taiwan J Obstet Gynecol 2010; 49: 72-6.
Oda N, Takeuchi K, Tanaka A, Maruo T. Obstetric risk factors associated with the development of periventricular leukomalacia in preterm infants born to mothers complicated by placenta praevia. Fetal Diagn Ther 2008; 24: 345-8.
Harper LM, Odibo AC, Macones GA, Crane JP, Cahill AG. Effect of placenta praevia on fetal growth. Am J Obstet Gynecol 2010; 203: 330. el-S.
Malik AM, Siddique S, Shah IA. Placenta praevia: a study to vitamin responsible factors. Prof Med J 2007; 14: 407-10.
Hall T, Wax JR, Lucas FI, et al. Prenatal sonographic diagnosis of placenta accrete impact on maternal and neonatal outcome. J clin Ultasound. 2014; 42: 449_455.
Bowman ZS, Eller AG, Kenndy AM, et al. Inter_observer variability of sonography for prediction of placenta accrete J ultrasound Med. 2014; 33: 2153_2158.
Taipale P, Orden MR, Berg M, Manninen H, Alafuzoff I. Prenatal diagnosis of placenta accreta and percreta with ultrasonography, color Doppler, and magnetic resonance imaging. Obstet Gynecol 2004; 104: 537-40.
Ruparelia BA, Chapman MG. Early low-lying placentae — ultrasonic assessment, progress and outcome. Eur J Obstet Gynecol Reprod Biol 1985; 20: 209—13.
McGahan JP, Philips HE, Reid MH. The anechoic retroplacental area: a pitfall in diagnosis of placental endometrial abnormalities during pregnancy. Radiology 1980; 134: 475-8.
Placenta accreta. ACOG Committee Opinion No. 266. American College of Obstetricians and Gynecologists. Obstet Gynecol 2002; 99: 169-170.
Pelosi MA, 3rd, Pelosi MA. Modified cesarean hysterectomy for placenta previa percreta with bladder invasion: retrovesical lower uterine segment bypass. Obstet Gynecol 1999; 93 suppl: 830—3.
Finberg HJ, Williams JW. Placenta accrete; prospective sonographic diagnosis in patients with placenta previa and prior caesarean section. J Ultrasound Med. 1992; 11: 333_43.
Lerner JP, Dean S, Timor_Tritsch IE. Characterazation of Placenta acccreta using transvaginal sonography and colour Doppler imaging. Uultrasound obstet Gynaecol. 1995; 5: 198_201.
Levine D, Huulka CA, Ludmir J, Li W, Edelman RR. Placenta acccreta: evaluation with colour Doppler US, power Doppler US, and MR imaging. Radiology. 1997; 205 (3): 773_6.
Chou MM, Ho ES, Lee YH. Prenatal diagnosis of placenta previa accrete by transabdominal colour Doppler ultrasound. Ultrasound Obstet Gynecol. 2000; 15: 28_35.
Shih JC, Palacios Jaraquemada JM, Su YN, Shyu MK, Lin CH, Lin SY, et al. Role of three- dimensional power Doppler in the antenatal diagnosis of placenta accreta: comparison with gray-scale and color Doppler techniques. Ultrasound Obstet Gynecol. 2009; 33: 193-203.
Browse journals by subject