Early Prediction of Placenta Accreta by Ultrasound and Color Doppler

Study Overview
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Brief Summary
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Placenta accreta is a substantially life threatening condition and one of the causes of maternal morbidity and mortality in the world. According to study done in United Kingdom, The estimated incidence of placenta accreta/increta/percreta was 1.7 per 10,000 maternities overall and 577 per 10,000 in women with both a previous cesarean delivery and placenta previa. in a tertiary south Italian center, The incidence increased from 0.12% during the 1970s, to 0.31% during the 2000s.While in United States of America, the prevalence of placenta accreta was 3.7 per 1000 deliveries.

Official Title
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Early Prediction of Placenta Accreta by 2 Dimensional Transvaginal Ultrasound and Color Doppler

Conditions
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Placenta Accreta

Intervention / Treatment
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* Device: two-dimensional ultrasound and color Doppler


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Low implantation of the gestational sac (<4 cm from external os) by transvaginal ultrasound Presence of placental lakes by transvaginal ultrasound Disruption of placental-myometrial interface by transvaginal ultrasound Trophoblast overlapping a uterine scar (Cesarean section, myomectomy) by transvaginal ultrasound Intraplacental dilated vessels by Doppler ultrasound Turbulent blood flows by Doppler ultrasound Greatly increased periplacental vascularity by Doppler ultrasound Exclusion Criteria: a) Cases far away from our hospital and expected to be lost to be followed. b) Pregnant women who will refuse to Participate -
Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| placenta accreta<br>Having at least one sign suggestive of placenta accreta | Device: two-dimensional ultrasound and color Doppler<br>* the eligible participants will be searched for signs suggestive of placenta accreta; low implantation of the gestational sac (<4cm from the external os), presence of placental lakes, Disruption of placental-myometrial interface and trophoblast overlapping a uterine scar by 2 dimensional transvaginal ultrasound and Intraplacental dilated vessels, turbulent blood flows and greatly increased periplacental vascularity by Doppler ultrasound by level II sonographer and co-investigator under his supervision using ultrasound device.<br>|
| normal placenta<br>Never having any of the signs suggestive of placenta accreta | Device: two-dimensional ultrasound and color Doppler<br>* the eligible participants will be searched for signs suggestive of placenta accreta; low implantation of the gestational sac (<4cm from the external os), presence of placental lakes, Disruption of placental-myometrial interface and trophoblast overlapping a uterine scar by 2 dimensional transvaginal ultrasound and Intraplacental dilated vessels, turbulent blood flows and greatly increased periplacental vascularity by Doppler ultrasound by level II sonographer and co-investigator under his supervision using ultrasound device.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Confirmation of occurrence of placenta accreta during delivery. |  | duration of pregnancy |