3D Power Doppler versus Grayscale and Color Doppler Sonography in Diagnosis of Placenta Accreta Spectrum. A Prospective Observational Cohort Study

Background: Placenta accreta is a major source of maternal morbidity and mortality and is currently the major reason for peripartum hysterectomy.Objectives: to evaluate the diagnostic performance of 3D power Doppler in the prenatal diagnosis of placenta accreta spectrum disorders versus grayscale ultrasound and color Doppler ultrasonography.Methods: Evaluation of 202 pregnant women with placenta previa with gestational age 28 to 30 weeks was done. All participants were subjected to Grayscale ultrasound and color Doppler US in addition to 3D power Doppler US before elective cesarean sections were done.Results: 3D power Doppler US; (VI) predicted severe placenta accrete spectrum disorders with sensitivity of 93.9% and specificity of 77.61%; while (placental volume) predicted it with sensitivity of 96.88% and specificity of 80.60%, 2D color Doppler US; (Lower uterine segment hypervascularity) with sensitivity of 88.24% and specificity of 90.91%, grayscale US; (retroplacental hypoechoic zone) with sensitivity of 73.13% and specificity of 69.63%.Conclusion: Antenatal ultrasound is the method of choice used to establish diagnosis and direct clinical management. After using 3D power Doppler ultrasonography, better results were obtained; and these were confirmed when compared with intra-operative findings.