DIAGNOSTIC ACCURACY OF DOPPLER ULTRASOUND IN DIAGNOSIS OF PLACENTA ACCRETA TAKING OPERATIVE FINDINGS AS GOLD STANDARD

Abstract

Background: This study sought to ascertain the diagnostic precision of Doppler ultrasonography in the diagnosis of placenta accreta using surgical findings as the gold standard. However, a thorough assessment is necessary to determine its diagnostic accuracy, with operational results being the gold standard. The performance of Doppler ultrasound will be investigated in order to improve clinical practice and, eventually, the treatment of placenta accreta, which may save lives and minimize difficulties.

Objective: to assess Doppler ultrasound's diagnostic accuracy for placenta accreta using surgical findings as the gold standard.

Methods: A cross-sectional study was conducted at LRH Peshawar, involving 72 pregnant females with suspected placenta accreta. Sensitivity, specificity, positive and negative predictive values, and other diagnostic accuracy metrics were determined by recording Doppler ultrasound results and comparing them with intraoperative findings. SPSS v.26 was used for statistical analysis.

Results: Among 72 participants (mean age 33.0 ± 5.1 years), 46 (63.9%) presented with antepartum hemorrhage. Doppler ultrasound demonstrated diagnostic accuracy of 83.3% (60/72), with sensitivity of 84.8% (28/33), specificity of 82.1% (32/39), PPV of 80.0% (28/35), and NPV of 86.5% (32/37). Stratified analysis showed highest accuracy in patients aged 40-44 years (100%), those with antepartum hemorrhage (87.0%), and those with ≥2 previous uterine surgeries (92.9-100%).

Conclusion: Doppler ultrasound demonstrated a notable diagnostic accuracy in detecting placenta accreta, with excellent sensitivity and specificity, taking operative findings as gold standard. It is a valuable non-invasive tool for prenatal diagnosis, particularly in high-risk patients with advanced age, antepartum hemorrhage, and multiple previous uterine surgeries