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  • Title: Prediction of placenta accreta by ultrasonography and color Doppler imaging.
    Author: Woodring TC, Klauser CK, Bofill JA, Martin RW, Morrison JC.
    Journal: J Matern Fetal Neonatal Med; 2011 Jan; 24(1):118-21. PubMed ID: 20446895.
    Abstract:
    OBJECTIVE: To determine the accuracy of ultrasound and color flow Doppler to diagnose placenta accreta. METHODS: Respectively, ultrasound images consistent with signs of placenta accreta (concomitant previa, numerous vascular lacunae, absent lower uterine segment between bladder-placenta, turbulent or complicated blood flow at the uteroplacental interface) were correlated with findings at the time of surgery and pathologic examination. RESULTS: Over 64 months, 12 cases with suspected placenta accreta by ultrasound were studied. The median gestational age at first diagnosis was 25 weeks and 92% had a previa while all had at least one previous cesarean delivery. At surgery, 83% (10/12) had an adherent placenta requiring hysterectomy (eight accreta, one increta, and one percreta). There were two false positives (one complete previa, one low-lying placenta with vasa previa). Nine of 12 women (75%) required blood transfusions due to a mean hematocrit nadir of 22.7 ± 4.6%. The mean number of packed red blood cell units transfused was 4.9 ± 4.7 units (range 2-17 units). CONCLUSION: Sonography coupled with color-flow Doppler appears helpful in allowing antenatal diagnosis of accreta.
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