Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Gynecology and Obstetrics

Objective: Evaluational study for the diagnosis of placenta accrete in Kasr El-Aini hospital through assessing the diagnostic methods used as gray-scale ultra-sonography and color Doppler techniques in the antenatal diagnosis of placenta accreta to the final diagnosis made during Cesarean delivery and by the histopathological examination, aiming to decrease maternal and neonatal morbidity and mortality. Methods: 24 pregnant women with persistent placenta previa anterior (after 28 weeks{u2019} gestation) were prospectively enrolled into this study diagnosed as placenta accrete by 1st line diagnostic methods Gray-scale transabdominal ultrasound examination was performed to detect loss of the subendometrial echolucent zone and other abnormalities suggestive of placenta accreta. Color flow mapping was used to scan the whole placenta to detect any newly formed vessels at the serosa{u2013}bladder border or the presence of abnormal lacunae. The ultrasound findings were analyzed with reference to confirm final diagnosis made during Cesarean delivery and histo-pathological examination. Results: Placenta accreta and its variants (including increta and percreta) were confirmed in all patients at the time of Cesareanas delivery, except one case diagnosed intraoperative focal placenta accrete, as placenta separate spontaneously except focal part adherence to part of the myometrium and managed by focal myometrium resection .Definitive diagnosis of placenta accreta was made at delivery when the myometrium was seen to be invaded by the placenta, and the histo- pathological examination of the removed uterus showed the villi attached to the myometrium without intervening decidua (accreta), invading into the myometrium (increta) or reaching the serosa (percreta)

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