Detecting Accuracy of Three Dimensional Power Doppler (3DPD) Vascular Indices for Prenatal Diagnosis of Morbidly Adherent Placenta in Patients with Placenta Previa

Abstract

Objective: The study's objective was to assess the accuracy of using prenatal 3-dimensional power Doppler analysis of vascular placental indices to accurately diagnose morbidly adherent placenta objectively. Background: Traditionally, 2D ultrasound was used for the diagnosis of a suspected morbidly adherent placenta (MAP) previa. More objective techniques like 3D power Doppler haven't been well studied. Study Design: A prospective cohort study is designed for women with gestational age between 28 and 32 weeks with suspected placenta previa. Patients were examined by 2D ultrasound which was used in management decisions. 3D Power Doppler's VI, FI and VFI were measured during the same examination after manual tracing of placenta; data were blinded to obstetricians. Histopathology was performed to confirm MAP. Results: Our results showed that the 3D power Doppler VI ≥ 16 predicted the diagnosis of MAP with 100% sensitivity, 100% specificity which is better than those of 2D ultrasound. While VI > 33.1 measured by 3D Doppler predicted severe MAP with a sensitivity of 73.9% and specificity of 86.4%, which was superior to 2D ultrasound. Conclusion: In patients with placenta previa, the 3D Doppler's vascular index accurately predicts MAP. Furthermore, vascular and vascular flow indices of 3D Doppler were more predictive of severe cases of MAP compared to 2D ultrasound.

Relationship of Placental Vascular Indices with Macroscopic, Histopathologic, and Intraoperative Blood Loss in Placenta Accreta Spectrum Disorders

“…ese findings were consistent with another study that compared these 3 placental vasculatures on morbidly adherent placenta (MAP). ey found that VI and VFI values were significantly higher in the MAP group than in normal pregnancy, with almost similar FI values [21]. ese data may support the fact that VI and VFI, but not FI, could be good placental vasculature markers for predicting the presence of PAS.…”