Accuracy of three-dimensional multislice view Doppler in diagnosis of placenta accreta spectrum
Objective. To evaluate the accuracy of three-dimensional multislice view Doppler as a diagnostic tool in the diagnosis of placenta accreta spectrum.
Materials and Methods. Seventy eight pregnant women with persistent placenta previa totalis (after 28 weeks’ gestation) were prospectively enrolled into this study. Gray-scale transabdominal ultrasound examination was performed to detect loss of the subendometrial echolucent zone and other abnormalities suggestive of placental invasion. Three-dimensional multislice view Doppler was used to scan the whole placenta to detect any vessels invading the uterine serosa-bladder interface or presence of abnormal lacunae. Ultrasound findings were analyzed with reference to histopathological results.
Results. Placenta accreta and its variants (increta and percreta) were confirmed in 39 women by pathological results. Diagnostic value of three-dimensional multislice view Doppler using 2 or more criteria of placental invasion showed a sensitivity of 87%, specificity of 96%, and accuracy of 91% (area under ROC curve [AUC] = 0.961). Disruption of the uterine serosa-bladder interface was the best single criterion for the diagnosis of placenta accreta (sensitivity = 95% and specificity = 96%).
Conclusions. Three-dimensional multislice view Doppler can be used as an accurate test for diagnosis of placenta accreta spectrum.