Placenta Accreta, Third Trimester Clinical Trial
Official title:
Gray-scale , Colour Doppler Ultrasound and Magnetic Resonance Imaging for Diagnosis of Placenta Accreta
This study aim to assess the accuracy of magnetic resonance imaging (MRI) compared to gray-scale and colour Doppler ultrasound (US) for the prenatal diagnosis of placenta accreta.
Placenta accreta occurs when the chorionic villi abnormally invade the myometrium. Based on
histopathology it is divided into three grades: placenta accreta (the chorionic villi are in
contact with the myometrium), placenta increta (the chorionic villi invade the myometrium),
and placenta percreta where the chorionic villi penetrate the uterine serosa. With increasing
rate of cesarean delivery, the incidence of both placenta praevia and placenta accreta is
steadily increasing in frequency.
Prenatal diagnosis of invasive placentation is associated with a reduced risk of maternal
complications as it allows a preplanned treatment of the condition . Gray-scale and colour
Doppler ultrasound (US) are valuable tools in the prenatal diagnosis of placenta accreta
.However, if the ultrasound ( US ) findings suggest possible percreta or are inconclusive or
negative in an at-risk woman, magnetic resonance imaging (MRI) can be useful.
Multiple sonographic findings are seen with placenta accreta such as decrease in myometrial
thickness, placenta previa, placental lacunae, abnormal pattern of color Doppler, loss of the
retroplacental clear zone and placenta percreta irregularities in wall of urinary bladder (
UB ) have been detected .
The most magnetic resonance imaging characteristic findings seen in placenta accreta are
nodular thickening in the dark zone of placenta-uterine interface together with extensions of
dark bands through the placenta, outer uterine bulge causing from the mass effect of the
placenta and heterogeneous signal intensity of placenta on the T2-weighted HASTE sequences
due to large placental lakes and vessels.
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