Khamis, R., Elhadary, A., Shaaban, M., Greash, M. (2023). Accuracy of Intracervical Blood lakes as an Ultrasonic Marker of Placenta Accreta in Patients with Placenta Previa. Suez Canal University Medical Journal, 26(9), 64-74. doi: 10.21608/scumj.2023.323929
Rasha E. Khamis; Athar Elhadary; Mohamed M. Shaaban; Mahmoud A. Greash. "Accuracy of Intracervical Blood lakes as an Ultrasonic Marker of Placenta Accreta in Patients with Placenta Previa". Suez Canal University Medical Journal, 26, 9, 2023, 64-74. doi: 10.21608/scumj.2023.323929
Khamis, R., Elhadary, A., Shaaban, M., Greash, M. (2023). 'Accuracy of Intracervical Blood lakes as an Ultrasonic Marker of Placenta Accreta in Patients with Placenta Previa', Suez Canal University Medical Journal, 26(9), pp. 64-74. doi: 10.21608/scumj.2023.323929
Khamis, R., Elhadary, A., Shaaban, M., Greash, M. Accuracy of Intracervical Blood lakes as an Ultrasonic Marker of Placenta Accreta in Patients with Placenta Previa. Suez Canal University Medical Journal, 2023; 26(9): 64-74. doi: 10.21608/scumj.2023.323929
Accuracy of Intracervical Blood lakes as an Ultrasonic Marker of Placenta Accreta in Patients with Placenta Previa
Department of Obstetrics and Gynecology, Faculty of Medicine, Suez Canal University, Egypt.
Abstract
Background:Placenta accreta spectrum disorder (PASD) describes an abnormal trophoblastic invasion of part or all the placenta into the myometrium. This study introduces a new ultrasonic sign, intracervical blood lakes (ICL) which are defined as tortuous anechoic spaces within the cervix, which appear to be hypervascular on color Doppler, which can be considered as the consequence of massive trophoblastic invasion of the uterine cervix leading to an intracervical disruption process. Aim: To evaluate the diagnostic accuracy of ICL in predicting the presence of PASD. Subjects and Methods: This was a prospective cohort study of 100 women with placenta previa at ≥ 24 weeks of gestation, who were referred to the Obstetrics and Gynecology Department, Suez Canal University Hospital, Ismailia, Egypt from August 2021 to September 2022. The presence of ICL was evaluated by trans-vaginal ultrasound at 24 and 35 weeks of gestation. Follow-up of patients till delivery was done to explore the accuracy of this sign in predicting major postpartum hemorrhage at the time of Cesarean section and the need for Cesarean hysterectomy (CH). Results: Cervical lakes had the highest specificity of (98.39%) in the second trimester and (95.16%) in the 3rd trimester for detection of accretions with overall diagnostic accuracy of 67% during the second trimester and 80% in the third trimester.Conclusion:ICL are associated with PASD representing a marker of deep villus invasion, and its incorporation into ultrasound examination may increase the diagnostic accuracy for prediction of CH and major postpartum hemorrhage in women with placenta previa.
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