Doppler Parameters of Uterine Arteries in the Evaluation of Placenta Accreta in Patients with Placenta Previa.

BACKGROUND

Placenta previa (PP) is an obstetric condition where the placenta is abnormally positioned in the lower uterine segment, potentially covering the cervical os. Placenta accreta (PA), often associated with PP, involves abnormal placental adherence to the myometrium, complicating delivery and increasing the likelihood of severe hemorrhage.

METHODS

This study retrospectively analyzed medical records of 167 patients diagnosed with PP from January 2018 to December 2022. Patients were divided into two groups based on the presence (n=113) or absence (n=54) of PA. Clinical parameters, including age, gestational weeks, BMI, obstetric history, and uterine artery blood flow parameters [peak systolic velocity (PSV), resistance index (RI), pulsatility index (PI)], were compared between the two groups. Statistical analysis involved independent samples t-tests, chi-square tests, and logistic regression to identify significant predictors of PA severity.

RESULTS

Significant differences were observed between the two groups in terms of gravidity, parity, abortions, cesarean sections, and uterine artery blood flow parameters. Patients with PA had higher gravidity, parity, abortion, and cesarean section rates, along with higher PSV and lower RI and PI values. Logistic regression identified PSV, RI, and PI as significant predictors of PA severity. ROC curve analysis confirmed the high predictive accuracy of these parameters, with AUC values indicating robust diagnostic performance.

CONCLUSION

This study highlights the importance of detailed prenatal evaluation, particularly uterine artery blood flow parameters, in predicting and managing PA in PP patients.