Prenatal diagnosis of placenta previa accreta by transabdominal color Doppler ultrasound
Abstract
OBJECTIVE: The aim of this study was to evaluate the efficacy of transabdominal color Doppler ultrasound in diagnosing placenta previa accreta. DESIGN: Eighty patients with persistent placenta previa underwent transabdominal B-mode and color Doppler ultrasound evaluation in the second and third trimesters because they had a high risk of placenta accreta. Color Doppler imaging criteria used included diffuse intraparenchymal placental lacunar flow; focal intraparenchymal placental lacunar flow; bladder-uterine serosa interphase hypervascularity; prominent subplacental venous complex; and loss of subplacental Doppler vascular signals. The color Doppler images were interpreted prospectively for signs of placenta previa accreta according to the exhibited color Doppler sonographic features. RESULTS: Sixteen of the 80 patients exhibited characteristic color Doppler imaging patterns highly specific for placenta accreta according to the preceding criteria, and 14 of these had histopathological proof of placenta accreta. Two patients had false-positive color Doppler imaging evidence mistaken for interphase hypervascularity caused by bladder varices. Thirteen patients underwent hysterectomy in the group suspicious for accreta. Of the 64 patients with negative color Doppler imaging results, three had placenta accreta, while two required cesarean hysterectomy; the remaining patient underwent uterine artery ligation for bleeding from the lower uterine segment. The sensitivity of color Doppler imaging in the diagnosis of placenta previa accreta was 82.4% (14/17) and the specificity was 96.8% (61/63). The positive and negative predictive values were 87.5% (14/16) and 95.3% (61/64), respectively. CONCLUSIONS: Variable vascular morphological patterns of placenta previa accreta were exhibited and categorized by transabdominal color Doppler sonography in the antenatal period. The identification of these specific vascular patterns had a positive impact on the peripartum clinical management of the affected patients.
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Changes in calcification and image quality limitations make subjective measurements uncompetitive.
“Although the challenging issues of placental maturity have been widely resolved, the changes in calci fi cation and image quality limitations make subjective measurements uncompetitive [7].”
From DilatedFormer: dilated granularity transformer network for placental maturity grading in ultrasound (2023) · cites this paper as [7]
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- Authors
- Chou, M. M., Ho, E. S. C., & Lee, Y. H.
- Affiliations
- Taichung Veterans General Hospital (TW)
- Venue
- Ultrasound in Obstetrics & Gynecology
- Publisher
- Wiley
- Published
- 2000-01
- Volume
- 15
- Issue
- 1
- Pages
- 28-35
- ISSN
- 0960-7692 (ISSN-L)
- 1469-0705
- OpenAlex
- W1991658030
- Cited by
- 284
- References
- 24
- Citations by year
- 2025: 6 · 2024: 7 · 2023: 12 · 2022: 6 · 2021: 13 · 2020: 10 · 2019: 10 · 2018: 17 · 2017: 16 · 2016: 13 · 2015: 18 · 2014: 18 · 2013: 15 · 2012: 10
- FWCI
- 4.27
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Ultrasound in Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Medical Research Council
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and fetal healthcare
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Health Sciences › Medicine › Biochemistry › Blood transfusion and management
- Keywords
- placenta previa accreta, prenatal diagnosis, diagnostic accuracy, cesarean hysterectomy, uterine artery ligation
- MeSH terms
- Abdomen, Adult, Cesarean Section, False Positive Reactions, Female, Gestational Age, Humans, Hysterectomy, Placenta Accreta, Placenta Previa, Pregnancy, Pregnancy Outcome, Pregnancy Trimester, Second, Pregnancy Trimester, Third, Prospective Studies, Risk Factors, Sensitivity and Specificity, Reproducibility of Results, Ultrasonography, Prenatal, Ultrasonography, Doppler, Color
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