Research Paper

Comparison of accuracy of ultrasonography and magnetic resonance imaging in prenatal diagnosis of placenta accreta

Rifat Amin, Junaid Ahmad Kazimi, Beenish Jeelani

  Abstract :

Background: Placenta accrete(PA) is a significant cause of maternal morbidity and mortality and is now the most common reason for emergent postpartum hysterectomy. Placenta accreta is a clinical and diagnostic challenge with increasing prevalence due to increasing number of pregnant patients undergoing primary and repeat cesarean sections. Accurate prenatalidentification of affected pregnancies allowoptimal obstetric management. USG and MRI are the only diagnostic modalities available for prenatal diagnosis of PA. Limited studies with a prospective paired study design have evaluated and compared the difference in diagnostic capabilities of MRI and USG in diagnosing Placenta accrete.Objective: The study was undertaken to compare the diagnostic accuracy of trans-abdominal ultrasonography and magnetic resonance imaging for prenatal diagnosis of placenta accreteMethods: The prospective paired study was conducted in the Department of Obstetrics and Gynaecology in collaboration with department of Radio diagnosis Sher-i-Kashmir Institute of Medical Sciences, Soura Srinagar over a period of two years i.e. august 2016 to august 2018. Antenatal women with high risk of placenta accrete; placenta previa in index pregnancy or history of previous LSCS, myomectomy or D&C were evaluated with USG at 28-30wks followed by MRI. Sonographic and MRI finding were compared with final diagnosis as determined at surgery and by pathological examination.Results: A total of fifty patients with high risk for placentaaccrete were evaluated with ultrasonography and MRI. Of these 50 patients, 25 patients had confirmation of placenta accrete at delivery. Sonography correctly identified the presence of placenta accrete in 23 of 25 patients (92% sensitivity, PPV88.5%) and absence of placenta accrete in 22 of 25 patients(88% specificity, NPV91.6%). MRI correctly identified the presence of placenta accrete in 21 of 25 patients(84% sensitivity, PPV77.7%) and absence of placenta accrete in 19 of 25(specificity 76%, NPV 82.6%). The difference in sensitivity(p vale 0.38) and specificity(p value 0.26) between sonography and MRI was not statistically significant.Conclusion:Both MRI and USG are reasonably accurate in diagnosing PA and no investigation is superior over other. For high risk patients initial screening should be done by ultrasound followed by MRI if inconclusive or negative results are obtained on USG


  Cite This Article:

COMPARISON OF ACCURACY OF ULTRASONOGRAPHY AND MAGNETIC RESONANCE IMAGING IN PRENATAL DIAGNOSIS OF PLACENTA ACCRETA, Rifat Amin, Junaid Ahmad Kazimi, Beenish Jeelani, INTERNATIONAL JOURNAL OF ADVANCES IN GYNAECOLOGY : Volume-3 | Issue-4 | December-2019

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