The accuracy of 3D-TUI and 3D power Doppler using Alalfy simple criteria in the diagnosis of placenta accreta spectrum

Abstract Background Placenta accreta is a potentially life-threatening obstetric condition that requires a multidisciplinary approach to management. The incidence of placenta accreta has increased and seems to parallel the increasing cesarean delivery rate. Women at greatest risk of placenta accreta are those who have myometrial damage caused by a previous cesarean delivery with either an anterior or posterior placenta previa overlying the uterine scar. Diagnosis of placenta accreta before delivery allows multidisciplinary planning in an attempt to minimize potential maternal or neonatal morbidity and mortality. Aim of the Work To compare between alpha-fetoproteine as biological marker & ultrasound & Doppler findings for prenatal predication of morbid adherent placentation in anterior placenta on scar of previous cesarean section. Patients and Methods The current study is a prospective cohort study, conducted at a tertiary center: Ain Shams University Maternity Hospital during the period between February 2018 and April 2019,where 150 pregnant women having placenta previa covering scar of previous uterine surgery had been recruited from the outpatient obstetrics clinic or emergency room and admitted to antepartum inpatient high risk service, but 50 patients were dropped out due to loss in follow up because of emergency antepartum haemorrhage & C.S., others escaped follow up. Results The results of the current study showed a significant association between all criteria of the 3DPD with multislice view and presence of placental adherence, need for added surgical steps, CS hysterectomy and bladder injury with sensitivity 83% & specificity 57%, PPV 76%, NPV 66%. Conclusion The current study suggests that AFP assay, it isn't good test alone as regards its sensitivity &specificity &its level of accuracy 55% as compared to 2D &3D power doppler with multislice view, so it is unreliable test alone for antenatal diagnosis of morbidly adherent placenta.

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Three-dimensional Ultrasonography and Three-dimensional Power Doppler in the Evaluation of Placenta Accreta Spectrum

Donald School Journal of Ultrasound in Obstetrics & Gynecology ◽

10.5005/jp-journals-10009-1580 ◽

2019 ◽

Vol 13 (1) ◽

pp. 4-9

Author(s):

Gabriella Minneci ◽

Giuseppe Cali ◽

Francesco Forlani

Keyword(s):

Placenta Accreta ◽

Power Doppler ◽

Three Dimensional ◽

Placenta Accreta Spectrum

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A 10-Year Retrospective Review of Prenatal Applications, Current Challenges and Future Prospects of Three-Dimensional Sonoangiography

Diagnostics ◽

10.3390/diagnostics11081511 ◽

2021 ◽

Vol 11 (8) ◽

pp. 1511

Author(s):

Tuangsit Wataganara ◽

Thanapa Rekhawasin ◽

Nalat Sompagdee ◽

Sommai Viboonchart ◽

Nisarat Phithakwatchara ◽

...

Keyword(s):

Quality Assurance ◽

Placenta Accreta ◽

Power Doppler ◽

Three Dimensional ◽

First Trimester ◽

Flow Volume ◽

Volume Data ◽

Measurement Protocol ◽

Placenta Accreta Spectrum

Realistic reconstruction of angioarchitecture within the morphological landmark with three-dimensional sonoangiography (three-dimensional power Doppler; 3D PD) may augment standard prenatal ultrasound and Doppler assessments. This study aimed to (a) present a technical overview, (b) determine additional advantages, (c) identify current challenges, and (d) predict trajectories of 3D PD for prenatal assessments. PubMed and Scopus databases for the last decade were searched. Although 307 publications addressed our objectives, their heterogeneity was too broad for statistical analyses. Important findings are therefore presented in descriptive format and supplemented with the authors’ 3D PD images. Acquisition, analysis, and display techniques need to be personalized to improve the quality of flow-volume data. While 3D PD indices of the first-trimester placenta may improve the prediction of preeclampsia, research is needed to standardize the measurement protocol. In highly experienced hands, the unique 3D PD findings improve the diagnostic accuracy of placenta accreta spectrum. A lack of quality assurance is the central challenge to incorporating 3D PD in prenatal care. Machine learning may broaden clinical translations of prenatal 3D PD. Due to its operator dependency, 3D PD has low reproducibility. Until standardization and quality assurance protocols are established, its use as a stand-alone clinical or research tool cannot be recommended.

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