Accuracy of Multi-slice 3D-Doppler over 2D-Doppler in diagnosis of morbidly adherent placenta

Abstract

Caesarean section (CS) is an important lifesaving operation for both mother and child, and its use has increased dramatically over the last decade. In women with placenta previa, the risk of placenta accreta varies from 2% in women younger than 35 years old with no previous caesarean section to 39% in women at or over 35 years of age with two or more caesarean sections. In the presence of these risk factors, the obstetrician must have a high index of suspicion for placenta accreta and take appropriate precautions. In particular, this condition must be included in the differential diagnosis in women with previous caesarean sections and anterior placentation. The three forms of morbidly adherent placenta (MAP): placenta accreta, increta and percreta, represent a significant obstetric challenge, at times resulting in life-threatening bleeding, bladder injuries and/or peripartum hysterectomy. An accurate prenatal diagnosis is required to reduce the risk of maternal/fetal morbidity and mortality. Morbidly adherent placenta can be diagnosed prenatally by different modalities although there is limitation of prenatal diagnosis as it is not histopathological diagnosis, but 2D ultrasound, 3D multi-slice Doppler, MRI have major role in prenatal diagnosis of morbidly adherent placenta.