Document Detail


Prenatal diagnosis of placenta previa accreta by transabdominal color Doppler ultrasound.
MedLine Citation:
PMID:  10776009     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
M M Chou; E S Ho; Y H Lee
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology     Volume:  15     ISSN:  0960-7692     ISO Abbreviation:  Ultrasound Obstet Gynecol     Publication Date:  2000 Jan 
Date Detail:
Created Date:  2000-05-25     Completed Date:  2000-05-25     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  28-35     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, Taichung Veterans' General Hospital, Chung Shan Medical and Dental College, Taiwan, Republic of China.
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MeSH Terms
Descriptor/Qualifier:
Abdomen
Adult
Cesarean Section
False Positive Reactions
Female
Gestational Age
Humans
Hysterectomy
Placenta Accreta / complications,  surgery,  ultrasonography*
Placenta Previa / complications,  surgery,  ultrasonography*
Pregnancy
Pregnancy Outcome
Pregnancy Trimester, Second
Pregnancy Trimester, Third
Prospective Studies
Reproducibility of Results
Risk Factors
Sensitivity and Specificity
Ultrasonography, Doppler, Color / methods*
Ultrasonography, Prenatal / methods*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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