Placenta Accreta Clinical Trial
Official title:
Comparison Between the Role of Transabdominal Ultrasound Versus Transvaginal Ultrasound in Evaluation of Placental Invasion in Cases of Placenta Previa Anterior Wall With Previous Uterine Scar
Objective:
To compare between the role of Transabdominal ultrasound versus Transvaginal ultrasound in
evaluation of placental invasion in cases of placenta previa anterior wall with previous
uterine scar applying the unified ultrasonographic descriptors suggested by the European
working group on abnormally invasive placenta "EW-AIP' Also to evaluate the sensitivity and
specificity of each criterion by comparing them with the final outcome of pregnancy Fifty
pregnant women with persistent placenta previa (after 28 weeks' gestation) were prospectively
enrolled into this study. Both transabdominal and transvaginal ultrasound were performed by
two different operators who were blinded to the results of each other.
the placenta was studied as regarding the exact loacalization and the unified descriptors
were applied and evaluated by TAS and TVS.
The ultrasound findings were analyzed with reference to the final diagnosis made during
Cesarean delivery and histopathological examination
Definitive diagnosis of Abnormally Invasive Placenta was made at delivery when the myometrium
was seen to be invaded by the placenta, and the pathological examination of the removed
uterus showed the villi attached to the myometrium without intervening decidua (accreta),
invading into the myometrium (increta) or reaching the serosa (percreta).
-Complete imaging using all diagnostic techniques (gray-scale, color Doppler) by both
transabdominal and transvaginal by two expert operators, then an offline analysis of the
acquired images & volumes was done Ultrasound examination was performed using a 2D ultrasound
system equipped with a 4-8-MHz trans-abdominal transducer and a 12 MHz transvaginal
transducer The transvaginal ultrasound was performed by a highly experienced operator whereas
the transabdominal ultrasound was performed by a less experienced one and both were blinded
from the results of each other Placenta was examined while the bladder was partially full
about 300 ml for adequate visualization and precise localization
The Examined placenta is considered to be suspicious of abnormal invasion in case of having
one or more of the unified descriptors described by the European working Group on Abnormally
Invasive Placenta "EW-AIP":
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