Role of Ultrasound and Magnetic Resonance in Evaluation of Placenta Accreta

Background: Placenta accreta (PA) is one of the most dangerous conditions of pregnancy . It occurs when there is an abnormal adherence of a part or entire of the placenta to the uterine wall with either partial or complete absence of the decidua basalis. The placenta may be abnormally adherent to the myometrium, or extend to invade other tissues (uterine serosa or urinary bladder). Objective: This study aimed to assess the effectiveness of MRI and ultrasound for diagnosing placental accretion during pregnancy. Methods: Forty-seven pregnant patients with persistent placenta previa (after 28 weeks) and ultrasound findings suggestive of possible accreta were included in this prospective study. By contrasting their findings with the surgical outcomes after Cesarean section, the diagnostic accuracy of MRI and ultrasound in identifying placental accreta was assessed. Results: The study included patients aged between 20 and 44 years, with a mean age of 32. The mean gestational age was 33 weeks, ranging from 33 to 36 weeks. The average parity on a 1-5 scale was 3.06 ± 1.19. When it came to diagnosing placenta accreta, greyscale and color Doppler ultrasound showed 100% sensitivity, 72% specificity, and 89% accuracy. With 91% sensitivity, 83% specificity, and 89% accuracy, MRI also demonstrated value in the diagnosis of accreta, particularly when the ultrasound results were inconclusive or the placenta was posterior. Conclusion: While MRI is used when ultrasound lacks sufficient clarity or as a second opinion for ambiguous findings, particularly with posterior placenta, ultrasound remains the first choice for screening placental invasion.