Is Color Doppler a Useful Complementary Technique to Gray-Scale in Early Detection of Placenta Accreta?

Objective: To assess the role of color Doppler as a complementary technique to grayscale in the early detection of placenta accreta. Material and Methods: One hundred and ten pregnant women with confirmed placenta previa complete centralize (after 28 weeks gestation) were included prospectively into this study. Gray-scale trans abdominal ultrasound examination was performed to detect loss of the retroplacental echo lucent 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-bladder border or the presence of abnormal lacunae. The ultrasound findings were analyzed with reference to the diagnosis made during Cesarean delivery. Results: Placenta accrete and its variants were confirmed in 33 patients at the time of cesarean delivery, if we considered the presence of at least one criterion to be diagnostic when using each ultrasound, then gray-scale would have a positive predictive value of (59.6%), followed by color Doppler (55.6%). The majority of patients with placenta accreta showed multiple characteristic features on ultrasound imaging. In contrast, those patients with a false-positive diagnosis (i.e. the final diagnosis was placenta Previa alone) tended to show isolated ultrasound markers of the condition. Conclusion: Color Doppler is not useful as a complementary technique to gray-scale in the early detection of placenta accrete.