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

To asses the value of adding grayscale to color doppler and power doppler techniques in the antenatal diagnosis of degree of placental invasion. Fifty pregnant women with persistent placenta previa (after 28 weeks{u2019} gestation) were prospectively enrolled into this study. Gray - scale transabdominal ultrasound examination was performed to detect loss of the subendometrial echolucent zone and other abnormalities suggestive of placental invasion. Color flow mapping was used to scan the whole placenta to detect any newly formed vessels at the serosa - bladder border or the presence of abnormal lacunae. The ultrasound findings were analyzed with reference to the final diagnosis made during cesarean delivery and histopathological examination. Placenta accreta and its variants (including increta and percreta) were confirmed in 17 patients at the time of cesarean delivery. As regards analysis of gray-scale criteria, thinning or disruption of the hyperechoic uterine serosa bladder interface was highly predictive PPV and specificity 100% followed by, irregular retroplacental sonslucent zone PPV 93.75% and specificity 96.97 %

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