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ORIGINAL ARTICLE
Year : 2019  |  Volume : 5  |  Issue : 2  |  Page : 89-93

Role of transabdominal ultrasound for prediction of invasion in placenta accreta spectrum


1 Department of Obstetrics and Gynaecology, King George Medical University, Lucknow, Uttar Pradesh, India
2 Department of Medicine, King George Medical University, Lucknow, Uttar Pradesh, India
3 Department of Radiodiagnosis, King George Medical University, Lucknow, Uttar Pradesh, India

Correspondence Address:
Rekha Sachan
Department of Obstetrics and Gynaecology, King George Medical University, C-28, Sec-J Aliganj, Lucknow - 226 024, Uttar Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jcrsm.jcrsm_40_19

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Background: Abnormal placentation has been classified into accreta, increta, and percreta on the basis of depth of myometrial invasion. The aim of the study was to evaluate the role of transabdominal ultrasonography (USG) for prediction of placental invasion in the placenta accreta spectrum. Materials and Methods: This was a prospective cohort study carried out over 1 year in the Department of Obstetrics and Gynecology in collaboration with the Department of Radiodiagnosis at King George's Medical University, Lucknow, Uttar Pradesh, India. A total of 110 patients were recruited for the study, of these 20 patients were lost to follow-up. After informed consent and ethical clearance, 90 pregnant women with gestation age of 34 weeks or above (late pregnancy) with previous cesarean section with complaints of bleeding per vaginum or diagnosed on USG as a case of placenta previa with or without accreta were enrolled for the study. Women not giving consent for participation in the study or not having any of above risk factors were excluded from the study. Results: Placental invasion was found in 61.1% (55) on USG. Women with previous two cesarean sections had a placental invasion rate of 74.5%. Women with previous three cesarean sections had the highest placental invasion rate (78.6%), and this association of placental invasion with the number of prior cesarean sections was significant. On transabdominal ultrasound, 68 patients had Grade 3 lacunae, of which 67.6% (46) had invasion. Maximum number of cases (n = 63) had the smallest sagittal myometrial thickness of <1 mm, and invasion was found in 69.8% (44). Out of 90 cases, placental invasion was found in 61.1% (55) by transabdominal USG, and 80% (72) of placental invasion was observed on histopathological examination. Conclusion: In the present study, Grade-3 lacunae, smallest sagittal myometrial thickness of <1mm and more than 1 prior cesarean delivery were associated with placental invasion on USG.


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