The Efficacy of Color Doppler Ultrasound in Diagnosis and Management of Placenta Previa with Accreta

Hong, Seong Hoon; Choi, Hyung Min; Kim, Yun Jin; Suh, Woon Hee

Abstract

OBJECTIVE
To evaluate the efficacy of color Doppler ultrasound in diagnosis and management of placenta previa with accreta.
METHODS
Hospital records were reviewed all cases of placenta previa from December 1999 to June 2002, and seventy-four patients with placenta previa underwent color Doppler ultrasound in their second and third trimester. Four diagnostic criteria of placenta accreta were diffuse lacunar flow pattern, exhibiting diffusely dilated vascular channels throughout the whole placenta: focal lacunar flow pattern showing irregular sonolucent vascular lakes, regionally or focally within the intraparenchymal placental area: absence of subplacental vascular signals in the areas lacking the peripheral subplacental hypoechoic zone: interphase hypervascularity with abnormal blood vessels linking the placenta to the bladder.
RESULTS
Twenty-four of the seventy-four patients diagnosed placenta previa with accreta according to the above criteria and thirteen of these have proven to placenta accreta histopathologically. In ten cases hysterectomy were done under the group of suspicious placenta accreta. The sensitivity, specificity, positive predictive value and negative predictive value were 100%, 83%, 56% and 100%.
CONCLUSION
The color Doppler ultrasound was effective method for the diagnosis of placenta previa with accreta, so proper diagnosis will be helpful to management of placenta previa with accreta patients.