Utility of placental acretism color Doppler ultrasound diagnossis at the ‘Hospital de Clínicas’

Authors

  • Martha Velgara Maldonado Cátedra de Ginecología y Obstetricia. Unidad de Alto Riesgo Obstétrico. Dpto. de Ecografía y Medicina Perinatal. Hospital de Clínicas. San Lorenzo. Facultad de Ciencias Médicas. Universidad Nacional de Asunción. Paraguay
  • MA González Ruíz Díaz Cátedra de Ginecología y Obstetricia. Unidad de Alto Riesgo Obstétrico. Dpto. de Ecografía y Medicina Perinatal. Hospital de Clínicas. San Lorenzo. Facultad de Ciencias Médicas. Universidad Nacional de Asunción. Paraguay

DOI:

https://doi.org/10.18004/

Keywords:

previous placental, acretismo, gestation, previous cesarean scar, Paraguay

Abstract

Introduction: The acretism pathology and his different levels are associate to previous placental and previous cesarean section scar, wich is a situation that keeps increasing in our service. The prenatal diagnosis is fundamental to programme and qualified attention and to avoid maternal death. Objective: To value the practicality of the ultrasound diagnosis in gray scale and Doppler Map on Prenatal diagnosis to presume the placental acretismo compared with quirurgicals finding. Methods and material: It is an long-term cohort research. Were included pregnant women on their third trimester with risk of placental acretism in prevous placenta. Form February 2009 to august 2010 at the “Centro Materno-Infantil del Hospital de Clínicas FCM-UNA.”, Cáthedra of Ginecology and Obstetrics has place. All the pacients went through Ultrasound obstetric in third trimester adding color Doppler Map.For the ultrasound and color Doppler protocol was on the research of acretism symptoms, counting with published items made by Finberg HJ and others. The research was made trough abdominal and transvaginal way, evaluating the miometrial wall, the serosa and the vesicle wall. Results: From 30 examinated pacients turno ut to be 10 pacients (33%) whom were diagnosed with high probabilities of acretism. The concordance to the gray scale ultrasound and the color Doppler map was 90%. The complementary analysis with color Doppler showed also percretism symptoms in 5 pacients (55, 5%) from 9 pacients comfirmed at the quirurgical act. Conclusions: The gray scale US, along with the color Doppler Map, it is a high value tool for the acretismo level in Placenta Previa and in pacients with previous scar records.

References

1. Miller DA, Chollet JA, Goodwin TM. Clinical risk factors for placenta previa-placenta accreta. Am J Obstet Gynecol 1997; 177: 210-4.

2. Simpkins F, Holcroft C. Hemorragia en el tercer trimestre. En Bankowski B J, Hearne A E, Lambrou NC. Fox NC, Wallach EE, editores. Johns Hopkins Ginecologìa y Obstetricia.Philadephia: Marbàn Libros, SL.2005.P.128- 132.

3. Chou MM, Tseng JJ, Ho ES, Hwang JI. Three dimensional color power Doppler imaging in the assessment of uteroplacental neovascularization in placenta previa increta/percreta. Am J Obstet Gynecol 2001; 185: 1257-60

4. O’Brien JM, Barton JR, Donaldson ES. The management of placenta percreta: conservative and operative strategies. Am J Obstet Gynecol 1996; 175:1632-8.

5. Clark SL. Placenta previa and abruptio placentae. En: Creasy RK, Resnik R (Eds.). Maternal-fetal medicine: principles and practice. 5th ed. Philadelphia: Saunders; 2004. P.707-22

6. Yang JI, Lim YK, Kim HS, Chang KH, Lee JP, Ryu HS. Sonographic findings of placental lacunae and the prediction of adherent placenta in women with placenta previa totalis and prior Cesarean section. Ultrasound Obstet Gynecol 2006;28:178-82.

7. Hoffman-Tretin F, Koenigsberg M, Rabin A, Anyaegbunam A. Placenta accreta. Additional sonographic obser vations. J Ultrasound Med 1992;11:29-34

8. Finberg HJ, Williams W. Placenta accreta: prospective sonographic diagnosis in patients with placenta previa and prior cesarean section. J Ultrasound Med 1992; 11:333-43.

9. Levine D, Hulka CA, Ludmir J, Li W, Edelman RR. Placenta accreta: evaluation with color Doppler US, power Doppler US and MR imaging. Radiology 1997; 205:773-6.

10. Taipale P, Orden M, Berg M, Manninen H, Alafusoff I. Prenatal diagnosis of placenta accreta and percreta, with ultrasonography, color Doppler, and magnetic resonance imaging. Obstet Ginecol 2004; 104(3):537-40

11. Comstock C. Antenatal diagnosis of placenta accreta: a review. Ultrasound Obstet Gynecol 2005; 26:89-96.

12. Aguilar-Hernández OF, Renan- Rivero y Coronado C, Sánchez-García JF, Bolio-Bolio MA. Rotura uterina por acretismo placentario. Ginecol Obstet Mex 2010; 78(4):250-253.

13. Ferreira-Narváez FE, Angulo-Carvallo M. Predicción del acretismo placentario con ultrasonido Doppler en el Hospital Universitario de Neiva (Colombia).Estudio de cohorte.Rev. Colomb Obstet Ginecol 2007; 57:290-5.

14. Warshak CR, Eskender R, Hull AD, Scioscia AL, Mattey RF, Benirschke K, et al. Accuracy of ultrasonography and magnetic resonance imaging in the diagnosis of placenta accreta. Obstet Gynecol 2006; 108: 573-81.

15. Espinoza R, Donoso E, Wild R. Histerectomía Obstetrica.Rec Chil Obstet Ginecol 1988; 53(6)329-33.

16. Chou MM, Ho ES, Lee YH. Prenatal diagnosis of placenta previa accreta by transabdominal color Doppler ultrasound. Ultrasound Obstet Gynecol 2000; 15:28-35.

17. Flood KM, Said S, Geary M, Robson M, Fitzpatrik C, Malone FD. Changing trends in peripartum hysterectomy over the last 4 decades. Am J Obstet Gynecol. 2009; 200:632-6.

18. Comstock CH, Love JJ Jr, Bronsteen RA, Lee W, Vettraino IM, Huang RR, et al. Sonographic detection of placenta accrete in the second and third trimesters of pregnancy. Am J Obstet Gynecol 2004;190:1135-4

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Published

2026-11-05

How to Cite

Utility of placental acretism color Doppler ultrasound diagnossis at the ‘Hospital de Clínicas’. (2026). Anales of the Faculty of Medical Sciences, 45(2), 15-24. https://doi.org/10.18004/