FREQUENCY OF PLACENTA ACCRETA ON DOPPLER STUDIES IN PATIENTS WITH PREVIOUS CAESARIAN SECTION

Placenta Accreta on Doppler Studies

Abstract

Objective: To determine frequency of placenta accreta in patients with previous Caesarian section on Doppler ultrasound examination.
Study Design: A Descriptive study.
Place and Duration: The study was conducted in Radiology Department CMH/MH Rawalpindi which is a tertiary care hospital from April 2006 to February 2007.
Patients and Methods: All patients who were pregnant and had previous LSCS were included in our study. The patients were included on the basis of Non-probability convenience sampling. Patients who had all previous normal deliveries were not included in our study. The method adopted on Doppler ultrasound studies placenta accreta in patients with previous caesarian section was confirmed in the first trimester if sac was low lying and attached to anterior wall of uterus with little or no myometrium between sac and bladder. In the second and third trimester visualization of multiple irregular vascular spaces/sinuses within placenta and visualized vascular bundles leaving the placenta and reaching lower part of bladder was diagnostic of accreta.
Result: We found the frequency of placenta accreta in patients with previous caesarian deliveries to be 3% (3/100) in CMH/MH Rawalpindi which is almost consistent with other studies performed in Pakistan and abroad. Out of 100 selected patients 3 were given suspicion of accreta on Doppler studies and confirmed to have accreta by our obstetrician and hysterectomy was done.
Conclusion: Placenta accreta is a life threatening condition with increase risk to mother morbidity and mortality. Doppler ultrasound is a reliable radiological technique to diagnose placenta accreta.