Evaluation of the sensitivity and specificity of 2D and color Doppler sonography in the detection of placenta accreta in pregnant women.

Introduction: Placenta accreta is the most common cause of bleeding leading to peripartum hysterectomy, and therefore, due to the importance of accreta in the mortality and morbidity of pregnant women, the correct diagnosis of the patient's final outcome is important. Therefore, this study aimed to evaluate the sensitivity, specificity, and accuracy of sonography diagnosis in the evaluation of placenta accreta by examining the two-dimensional (2D) and color Doppler sonography findings.

Materials And Methods: Sonography was done for detection of accreta from pregnant women who were suspicious of placenta accreta in the third trimester of pregnancy. They were evaluated to confirm placenta histology for accreta and clinical examination after cesarean surgery at Maternity Ward, Ahvaz Imam Khomeini Hospital. Then they were evaluated as an overview and for the lack of accreta sonography findings. The data collected were analyzed by SPSS V 24.

Results: About 58 patients (55.8%) of 103 pregnant mothers suspected of accreta with anterior placenta with an average age of 32.9 years after cesarean section were clinically extraordinarily positive and 45 patients (43.3%) were negative. The overall sensitivity and specificity of sonography for the detection of accreta placenta were 97.7% and 86.2%, respectively, which were most sensitive to diffuse and focal lacunar flow (100%) and the least sensitivity (33.3%) was observed for bladder wall interruption. Accuracy, positive predictive value, and negative predictive value of sonography for the diagnosis of accreta placenta with at least one diagnostic criteria were 91.2%, 84.6%, and 98.3%, respectively.

Conclusion: Sonography, as an affordable and inexpensive diagnostic method, can be worthy by examining placenta for the detection of accreta, which can increase the diagnostic accuracy when combining 2D criteria with color Doppler.