The Diagnostic accuracy of Ultrasound and Color Doppler Imaging in predicting of Placenta Accreta Spectrum

Abstract

Background: Placenta accreta spectrum (PAS) is a significant contributor to maternal mortality and morbidity. This disorder occurs when the placenta abnormally attaches to the uterus. The worldwide increase in cesarean sections (CS) has led to a rise in its prevalence. Timely diagnosis is crucial as it enables effective patient counseling, enhances the quality of care through multidisciplinary management for the mother and fetus, and optimizes the conditions for a successful cesarean delivery. We aimed to evaluate the accuracy of ultrasound (US) and color Doppler imaging in predicting PAS. Method: In this prospective study, 60 pregnant women with placenta previa (after 28 weeks) who were at high risk of placenta accreta took part. An imaging study involving grayscale US and Doppler was conducted over a period of nine months. With operative data as a reference standard, US and Doppler imaging were evaluated for their diagnostic accuracy in predicting PAS. Results: A statistically significant correlation has been observed between PAS and the quantity of prior CS. The association between PAS and age, gestational age, gravida, parity, abortion, or comorbidities is statistically not significant. The relationship between all placental bulges and bridging vessels and the presence of PAS is statistically non-significant. The most accurate US findings to diagnose PAS is the abnormal lacunae followed by loss of clear zone. Regarding Doppler findings, vascular clusters are the most accurate, followed by fetal artery traversing. Conclusion: The US and color Doppler performed well in predicting PAS.