Accuracy of 2D ultrasound and doppler ultrasound findings for the diagnosis of placenta accreta in pregnant women with risk factors

Abstract

Objective: To determine the accuracy of 2D ultrasound and Doppler ultrasound for the diagnosis of placenta accreta in pregnant women with risk factors. Materials and methods: Study of diagnostic accuracy for the assessment of placenta accreta in high-risk patients who ended their pregnancy between 2014 and 2016 at Hospital Universitario de Santander. After obtaining their informed consent, 51 pregnant women over 18 years of age, more than 12 weeks of gestational age, low or anterior placenta or a history of uterine surgery were included. The diagnosis of a high probability of placenta accreta based on the presence of at least two ultrasound criteria and one Doppler criterion was compared to the gold standard of the visual finding during the cesarean section and of the surgical specimen in patients taken to hysterectomy, or during the clinical course in women with vaginal delivery. Sociodemographic and clinical variables are described, and the sensitivity and specificity, and positive or negative odds ratios are estimated. Results: The diagnosis of high probability of placenta accreta based on 2D Doppler Ultrasound has a high sensitivity of 88.2% (95% CI: 70.0-100) and specificity of 97.1% (95% CI: 89.9-100), with positive LR of 30.0 (95% CI: 4.3-208.5) and negative LR of 0.12 (95% CI: 0.03-0.45). Conclusions: The diagnosis of high probability of placenta accreta using non-invasive imaging provides valuable information regarding the presence and extent of placenta accreta in patients with known risk factors.