Prenatal Diagnosis of Placenta Accreta by Colour Doppler Ultrasonography: 5-Year Review
Densak Pongrojpaw MD*, Athita Chanthasenanont MD*, Tongta Nanthakomon MD*, Komsun Suwannarurk MD*
Affiliation : * Maternal Fetal Medicine Unit, Department of Obstetrics and Gynaecology, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
Objective : To determine the accuracy of colour Doppler ultrasonography to diagnose placenta accreta.
Material and Method: The authors reviewed cases of placenta accreta between January, 2008 and December, 2012.
Ultrasonographic images consistent with signs of placenta accreta (numerous vascular lacunae, loss of subplacental sonolucent
space, absent lower uterine segment between bladder-placenta, turbulent or complicated blood flow at the uteroplacental
interface) were correlated with findings at the time of surgery and pathologic examination.
Results : Over 60 months, 12 cases (0.48/1,000 deliveries) with suspected placenta accreta by ultrasonography were studied.
The median gestational age at first diagnosis was 24 weeks. All cases had at least one previous cesarean delivery. At surgery,
all cases had an adherent placenta requiring hysterectomy (five accreta, three increta, and four percreta). Four cases (33%)
had accidental tear of urinary bladder. Nine cases (75%) required blood transfusions.
Conclusion : Colour Doppler ultrasonography appears useful in antenatal diagnosis of placenta accreta.
Keywords : Placenta accreta, Doppler ultrasonography, Prenatal diagnosis
