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Objective: To determine the diagnostic role of Doppler Ultrasound in morbidly adherent placenta (MAP) in patients with previous caesarean sections, keeping operative finding as gold standard.
Study Design: Cross sectional, Descriptive study.
Setting and Duration: The study was conducted at the Department of Radiology Dow Medical College and Civil Hospital Karachi from December 2015 to October 2016.
Methodology: This study enrolled 446 gravid females with previous history of Caesarean Sections. All of these patients referred to the Radiology Department for Obstetrical and Doppler Ultrasound. Ultrasound scan findings were interpreted by senior Sonologist / Radiologist followed by per operative (Caesarean Section) findings which were recorded from surgical/operative notes. Data was entered and analyzed by using SPSS version 21. Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of Doppler ultrasound were calculated. Stratification was done to observe effect of modifiers on the accuracy through chi-square test and hence P≤0.05 was considered as significant.
Results: The mean age was 31.4±4.93 years. The mean gestational age was 31.8± 2.7 weeks and the mean numbers of previous Caesarean Sections were 2.94±0.94. Sensitivity, Specificity, PPV, NPV and accuracy were 95.9%, 88.2%, 94.0%, 91.8%, and 93.3% respectively.
Conclusion: This study concluded a higher diagnostic accuracy of transabdominal Color Doppler ultrasound for the diagnosis of morbidly adherent placenta. It is a very useful, safe and easily available modality for evaluation of potentially life threatening obstetric disorder.
Nasreen Naz, Sassui Memon, Ayesha Isani Majeed. (2016) Diagnostic Role of Doppler Ultrasound in Morbidly Adherent Placenta (MAP): An Obstetrical Emergency, Journal of the Society of Obstetrics and Gynaecologists of Pakistan , Volume-06, Issue-4.
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