2. Subjects and methods
2.1. Subjects
The current study had been approved by Kasr ElAini Hospital,
Cairo University; all the included cases gave informed
consent.
Thirty-six pregnant females presenting with placenta previa
had been evaluated in the current prospective study from the
period from January 2010 till June 2011. Such cases were at
high risk for placenta accreta regarding their clinical history
of either one or all of the following: (1) maternal age > 35 -
years, (2) grand multiparity, (3) previous uterine interventional
procedures (e.g. cesarean sections, dilatation & curettage and
myomectomy) in addition to the major co-existing factor
which is placenta previa.
Their ages ranged from 25 to 38 years (mean age: 32.2 years).
2.2. Methods
Almost all of the cases (35/36 cases) were subjected to both
ultrasound (US) and magnetic resonance imaging (MRI) of
the pelvis prior elective delivery (P36 weeks gestation).
One case (1/36) had been examined only by MRI examination
just before cesarean delivery.
2.2.1. Ultrasound examination
Scanning was performed using LOGIQ 7 PRO, GE (General
electric medial system) ultrasound machine where:
(1) Transabdominal approach for all cases using 5 MHz sector
transducer (done by E.W. & M.S.).
(2) Translabial approach (done by M.S.) using 7–8 MHz
endoluminal transducer was performed in 20 cases
when placenta accreta was suspected and the interface
between the myometrium and the urinary bladder was
not clear due to: (i) considerable obesity and/or (ii) inadequate
bladder filling; translabial US was done by introducing
the tip of the endoluminal probe between the labia
minor.