Prediction of morbidly adherent placenta using Two-dimensional versus Three-dimensional Ultrasound Using Crystal Vue®: Diagnostic Test Accuracy Study

Abstract

Background: Ultrasonography offers unique qualities including real-time imaging, physiologic measurement, use of non-ionizing radiation and no known bio-effects in the diagnostic range, while being non-invasive. Sonographic image quality has increasingly benefited from electronic technology. Aim and objectives: was to evaluate the diagnostic accuracy of the transvaginal 2D ultrasound versus abdominal 3D Ultrasound Crystal Vue® software in order to predict Morbidly Adherent Placenta (MAP) according to the scoring system of RCOG. Patients and methods: This prospective study was conducted on 185 patients at Special care center of fetus, Ain Shams University Maternity Hospital, Cairo, Egypt from June 2019 to June 2020 after approval of the study protocol by local ethical committee. Results: The analysis of results revealed that taking all placental and intraoperative findings in account, 3D ultrasonography had a high agreement with intraoperative placenta findings, while 2D had a moderate agreement, Number of cases detected by 2d ultrasound were 125 out of 140 cases diagnosed as accreta intraoperativly (kappa value 0.544). Number of cases detected by 3d ultrasound was 135 out of 140 cases diagnosed as accreta intraoperativly (kappa value 0.827). Conclusion: 3D ultrasound has higher diagnostic accuracy (96.8%) versus 2D ultrasound (88.6%) .We recommend prenatal 3D ultrasound especially using Crystal Vue® software for all patients with MAP.