Placenta accreta in women with prior uterine surgery: Diagnostic accuracy of Doppler ultrasonography and MRI

Aim

To test and compare the sensitivity and accuracy of color Doppler and MRI in prenatal diagnosis of placenta accreta (PA) in gravid uterus with prior surgery.

Patients and methods

Twenty eight gravid women with prior uterine surgery and abnormal placental position were collected after meeting the inclusion criteria depending on gray scale sonographic findings which suggested placenta accreta. Color Doppler and MRI findings were classified as positive and negative according to presence or absence of imaging criteria of placenta accreta. The sensitivity and accuracy of color Doppler and MR imaging were compared.

Results

The surgical and pathological reports of our patients confirmed placenta accreta in 11/28 (39%) patients. According to color Doppler 15/28 (53%) patients were positive and 13/28 (46%) were negative for placenta accreta with sensitivity 90%, accuracy 78%, and specificity 70%. According to MRI findings 14/28 (50%) patients were positive for placenta accreta and 14/28(50%) were negative, with sensitivity 90%, accuracy 82%, and specificity 77%.

Conclusion

Color Doppler and MRI were useful in the diagnosis of placenta accreta with the same sensitivity and positive impact on the peripartum clinical management.