The Role of Color Doppler Ultrasonography and Magnetic Resonance in the Prenatal Diagnosis of Placenta Accrete

Background: Placenta accrete is a clinical and diagnostic challenge that is being with increasing frequency and may lead to catastrophic blood loss and related complications. Color doppler ultrasonography and magnetic resonance imaging are considered as specific imaging modalities and have very important role in the prenatal diagnosis of placenta accreta. Objectives: The aim of the current work was to evaluate the diagnostic value of color doppler ultrasonography and magnetic resonance imaging in the prenatal assessment of placenta accreta. Patients and Methods: This study was conducted on 40 pregnant women (from 32 to 40 weeks of pregnancy) with placenta previa and presented with manifestations of suspected placenta accreta. Their age ranged from 19 to 40 years with mean age of 31.8 years. All cases were subjected to ultrasound examination, but MRI was done in 33 cases prior to elective delivery. Results: Cases diagnosed of having placenta accreta were 18 out of 40 cases (45 %). Among those 18 cases; placenta found tobe accreta in 6 patients, increta in 7 patients and percreta in 5 patients. Our study showed high statistical significance between occurrence of Placenta accrete & prior uterine surgeries as a risk factor. Overall accuracy of ultrasound was 88%, while that of MRI was 85%. Ultrasound showed better specificity (86%) than that of MRI (81%), but MRI showed better sensitivity (92%) than that of ultrasound (89%). Conclusion: It could be concluded that both ultrasound and magnetic resonance have fairly good sensitivity and specificity for prenatal diagnosis of placenta accreta. Color doppler ultrasound remains the first primary screening imaging modality used to evaluate suspected placenta accreta and MRI is suggested as an alternative complementary tool to ultrasound in cases with inconclusive criteria.