Role of Doppler Ultrasound in Diagnosis of Invasion of Placentation Tissue
DOI:
https://doi.org/10.69667/lmj.2517303Keywords:
Doppler Ultrasound, Diagnosis, Invasion, Tissue.Abstract
Placenta previa is a severe complication of pregnancy and is the most common cause of postpartum hemorrhage, which often endangers the lives of pregnant women. In patients with malignant placenta previa and placenta accreta, ultrasound can display obvious blood flow changes, such as abnormal blood flow in the placental cavity, abundant blood flow signals, placenta accreta, a thinned echo zone between the uterus and placenta, an enlarged cervix, and thinned myometrium. Color Doppler ultrasound can accurately identify whether it is complete placenta previa. This study was conducted to assess the role of Doppler ultrasound in the diagnosis of invasion of the placental tissue. The study was a retrospective descriptive study conducted at Aljala Maternity Hospital in Tripoli during the years 2020-2021. Among 120 pregnant women were selected from medical files, and a predesigned questionnaire was formed to collect data from patients by simple random sampling methods. The data was coded and analyzed by using SPSS (Statistical Package for the Social Sciences) version 20. All variable results were considered statistically significant with a P value less than 0.05. Among 120 pregnant women who were diagnosed with placental invasion, the mean age group was 29.45 ± 5.345 SD, the minimum age was 18 years, and the maximum age was 45 years. Regarding the obstetric history, the mean gravidity was 3.37 ± 1.942 SD, the mean parity was 1.76 ± 1.559 SD, the mean miscarriage rate was 1.71 ± 0.454 SD, and the mean gestational age at time of diagnosis was 6.21 ± 2.111 SD. Regarding the prior experience with abnormal placentation in previous pregnancy, 66.3% had experienced it. Regarding the Doppler ultrasound approach, 73% of patients had abnormal Doppler findings on assessment. Regarding the prevalence of complications among participants who were diagnosed with placental invasion and the most commonly recognized complications were wound infection and thromboembolism, which both account for 63.5%. On assessing the placental invasion by Doppler ultrasound, this approach had a significant impact on evaluating pregnancy. Therefore, early utilization of Doppler is recommended, particularly in high-risk groups, to evaluate and detect serious health outcomes related to placental invasion.
References
Baumfeld Y, Herskovitz R, Niv ZB, Mastrolia SA, Weintraub AY. Placenta associated pregnancy complications in pregnancies complicated with placenta previa. Taiwan J Obstet Gynecol. 2017;56(3):331-5. PubMed PMID: 28600042.
Weiner E, Miremberg H, Grinstein E, Mizrachi Y, Schreiber L, Bar J, et al. The effect of placenta previa on fetal growth and pregnancy outcome, in correlation with placental pathology. J Perinatol. 2016;36(12):1073-8. PubMed PMID: 27654492.
Kollmann M, Gaulhofer J, Lang U, Klaritsch P. Placenta praevia: incidence, risk factors and outcome. J Matern Fetal Neonatal Med. 2013;29(9):1395-8. PubMed PMID: 23952619.
Jauniaux E, Bhide A, Kennedy A, Woodward P, Hubinont C, Collins S. FIGO consensus guidelines on placenta accreta spectrum disorders: Prenatal diagnosis and screening. Int J Gynaecol Obstet. 2018;140(3):281-90. PubMed PMID: 29352753.
Luke RK, Sharpe JW, Greene RR. Placenta accreta: the adherent or invasive placenta. Am J Obstet Gynecol. 1966;95(5):660-8. PubMed PMID: 5914492.
Committee on Obstetric Practice. Committee opinion no. 529: placenta accreta. Obstet Gynecol. 2012;120(1):207-11. Royal College of Obstetricians and Gynaecologists. Placenta praevia, placenta praevia accreta and vasa praevia: diagnosis and management. Green-top guideline No. 27. London: RCOG; 2011.
Han Y, Zhang Y, Chen L, et al. Diagnostic effect of transabdominal ultrasound combined with magnetic resonance imaging on pernicious placenta previa and pregnancy outcome. Imaging Sci Photochem. 2020;38(4):657-62.
Liu J, Xie XQ. Influence of different attachment sites of placenta previa on maternal and child outcomes of re-pregnancy after cesarean section. China Mod Med. 2014;21(34):12-5.
Baba Y, Matsubara S, Ohkuchi A, Usui R, Kuwata T, Suzuki H, et al. Anterior placentation as a risk factor for massive hemorrhage during cesarean section in patients with placenta previa. J Obstet Gynaecol Res. 2014;40(5):1243-8. PubMed PMID: 24612183.
Matsubara S, Kuwata T, Usui R, Watanabe T, Izumi A, Ohkuchi A, et al. Important surgical measures and techniques at cesarean hysterectomy for placenta previa accreta. Acta Obstet Gynecol Scand. 2013;92(4):372-7. PubMed PMID: 23278243.
Fukushima K, Fujiwara A, Anami A, Fujita Y, Yumoto Y, Sakai A, et al. Cervical length predicts placental adherence and massive hemorrhage in placenta previa. J Obstet Gynaecol Res. 2012;38(1):192-7. PubMed PMID: 21917085.
Hasegawa J, Matsuoka R, Ichizuka K, Mimura T, Sekizawa A, Farina A, et al. Predisposing factors for massive hemorrhage during Cesarean section in patients with placenta previa. Ultrasound Obstet Gynecol. 2009;34(1):80-4. PubMed PMID: 19472327.
Yeniel AO, Ergenoglu AM, Itil IM, Askar N, Meseri R, et al. Effect of placenta previa on fetal growth restriction and stillbirth. Arch Gynecol Obstet. 2012;286(2):295-8.
Getahun D, Oyelese Y, Salihu HM, Ananth CV. Previous cesarean delivery and risks of placenta previa and placental abruption. Obstet Gynecol. 2006;107(4):771-8.
Chattopadhyay SK, Kharif H, Sherbeeni MM. Placenta praevia and accreta after previous caesarean section. Eur J Obstet Gynecol Reprod Biol. 1993;52(3):151-6. PubMed PMID: 8124998.
Yu L, Hu KJ, Yang HX. A retrospective analysis on the pernicious placenta previa from 2008 to 2014. Zhonghua Fu Chan Ke Za Zhi. 2016;51(3):169-73. PubMed PMID: 27030493.
Naji O, Wynants L, Smith A, Abdallah Y, Saso S, Stalder C, et al. Does the presence of a Caesarean section scar affect implantation site and early pregnancy outcome in women attending an early pregnancy assessment unit? Hum Reprod. 2013;28(6):1489-96. PubMed PMID: 23539610.
Jauniaux E, Jurkovic D. PAS disorders: pathogenesis of a 20th century iatrogenic uterine disease. Placenta. 2012;33(4):244-51. PubMed PMID: 22197624.
Sholapurkar SL. Increased incidence of placenta praevia and accreta with previous caesareans—a hypothesis for causation. J Obstet Gynaecol. 2013;33(8):806-9. PubMed PMID: 24127953.
Eshkoli T, Weintraub AY, Sergienko R, Sheiner E. Placenta accreta: risk factors, perinatal outcomes, and consequences for subsequent births. Am J Obstet Gynecol. 2013;208(3):219.e1-7. PubMed PMID: 23313723.
Garmi G, Goldman S, Shalev E, Salim R. The effects of decidual injury on the invasion potential of trophoblastic cells. Obstet Gynecol. 2011;117(1):55-9. PubMed PMID: 21173648.
Aggarwal R, Suneja A, Vaid NB, Yadav P, Sharma A, Mishra K. Morbidly Adherent Placenta: A Critical Review. J Obstet Gynaecol India. 2012;62(1):57-61. PubMed PMID: 23372293.
Suknikhom W, Tannirandorn Y. Previous uterine operation and placenta previa. J Med Assoc Thai. 2011;94(3):272-7. PubMed PMID: 21560835.
Fitzpatrick KE, Sellers S, Spark P, Kurinczuk JJ, Brocklehurst P, Knight M. Incidence and risk factors for placenta accreta/increta/percreta in the UK: a national case-control study. PLoS One. 2012;7(12):e52893. PubMed PMID: 23300807.
Ayaz A, Farooq MU. Risk of adverse maternal and peri-natal outcome in subjects with placenta previa with previous cesarean section. Kurume Med J. 2012;59(1-2):1-6. PubMed PMID: 23257596.
Roberge S, Boutin A, Chaillet N, Moore L, Jastrow N, Demers S, et al. Systematic review of cesarean scar assessment in the nonpregnant state: imaging techniques and uterine scar defect. Am J Perinatol. 2012;29(6):465-71. PubMed PMID: 22399214.
Tseng JJ, Chou MM. Differential expression of growth-, angiogenesis- and invasion-related factors in the development of placenta accreta. Taiwan J Obstet Gynecol. 2006;45(2):100-6. PubMed PMID: 17197348.
Jauniaux E, Bhide A, Kennedy A. FIGO consensus guidelines on placenta accreta spectrum disorders: Prenatal diagnosis and screening. Int J Gynaecol Obstet. 2018;140(3):274-80. PubMed PMID: 29352753.
Downes KL, Hinkle SN, Sjaarda LA. Previous prelabor or intrapartum cesarean delivery and risk of placenta previa. Am J Obstet Gynecol. 2015;212(5):669.e1-6.
Robinson KA, Kriegshauser JS, Dahiya N. Detection of transplant renal artery stenosis determining normal velocities at the renal artery anastomosis. Abdom Radiol (NY). 2017;42(1):254-9.
