Comparing the Efficacy of Two-Dimensional Ultrasound and Three-Dimensional Power Doppler for Diagnosing Placenta Accreta Spectrum Disorders and Predicting Complications: A Prospective Cross-Sectional Study.

Abstract

Background: Placenta accreta spectrum (PAS) issue has become a noteworthy dangerous obstetrical issue because of its expanded rate from 0.12 to 0.31% in the last 30 years and the detailed death of roughly 7.0%.Objectives: To compare between the two-dimensional ultrasound and three-dimensional power Doppler for diagnosis of Placenta accrete spectrum disorders and prediction of its complications.Patients and methods: This was a prospective cross sectional single-institute study carried out on 86 patients suspected to have PAS-disorders by Two dimensional ultrasound 2D US and color Doppler during ANC at Obstetrics and Gynecology department, Minia maternity University Hospital from July 2021 to July 2022.Results: There was highly statistically significant difference as regards histopathology findings of 2D US (MAP, Non-MAP and Total) P<0. 001. VI, FI, and VFI were significantly higher among patients with MAP compared to patients without P<0. 001. The 2D US sensitivity was 87.3%, specificity was 90.3%, NPV was 80% and PPV was 94.1% with accuracy of 88.4% in diagnosis of MAP. 70.9% of the patients suffered from hemorrhage, 6.9% suffered from bladder injury, 10.5% reported preterm birth, and 3.5% suffered from bowel injury.Conclusion: 3D power Doppler can be used as a complementary technique to 2D ultrasound for confirmation of the diagnosis of placental invasion owing to its high sensitivity.