Pre-Operative Detection of Placental Invasion by USG & MRI in Case of Placenta Previa and its Correlation with Clinical Findings and Outcome

Objective: The purpose of this study was to evaluate transabdominal pelvic ultrasound and MRI for the prenatal diagnosis of placenta previa and its correlation with clinical outcome. Materials and Methods: A historical cohort pilot study was performed at our institution to identify women at risk of placenta accreta who had undergone both prenatal ultrasound and MRI. Findings at ultrasound and MRI were compared with the final diagnosis, which was established with clinical findings at delivery and pathologic examination of specimens. Volume measurements were made of low-signal-intensity intraplacental bands on T2-weighted MR images. Risk factors for placental insufficiency were recorded. Results: US and MRI showed no significant difference in sensitivity and specificity in diagnosing abnormal placentation (97 to 100% and 9 to100%, respectively). MRI was more sensitive than US for the detection of myometrial invasion and the type of abnormal placentation (73.5% and 47%, respectively). The difference between pre- and post-operative hemoglobin values and estimated blood loss were the most significant risk factors for abnormal placentation, added to risk factors known for placenta previa. Post-partum surgical complications and prolonged hospital stay were more common in the cases of placenta previa with abnormal placentation, however statistically insignificant.

Author(s): Leela R, Mamata N, Sudha Rani V and Narender Reddy P

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