title: Accuracy of three-dimensional multislice view Doppler in diagnosis of morbid adherent placenta.
abstract: OBJECTIVE
  To detect the accuracy of the three-dimensional multislice view (3D MSV) Doppler in the diagnosis of morbid adherent placenta (MAP).
  
  
  METHODS
  Fifty pregnant women at ≥28 weeks gestation with suspected MAP were included in this prospective study. Two dimensional (2D) trans-abdominal gray-scale ultrasound scan was performed for the subjects to confirm the gestational age, placental location, and findings suggestive of MAP, followed by the 3D power Doppler and then the 3D MSV Doppler to confirm the diagnosis of MAP. Intraoperative findings and histopathology results of removed uteri in cases managed by emergency hysterectomy were compared with preoperative sonographic findings to detect the accuracy of the 3D MSV Doppler in the diagnosis of MAP.
  
  
  RESULTS
  The 3D MSV Doppler increased the accuracy and predictive values of the diagnostic criteria of MAP compared with the 3D power Doppler. The sensitivity and negative predictive value (NPV) (79.6% and 82.2%, respectively) of crowded vessels over the peripheral sub-placental zone to detect difficult placental separation and considerable intraoperative blood loss in cases of MAP using the 3D power Doppler was increased to 82.6% and 84%, respectively, using the 3D MSV Doppler. In addition, the sensitivity, specificity, and positive predictive value (PPV) (90.9%, 68.8%, and 47%, respectively) of the disruption of the uterine serosa-bladder interface for the detection of emergency hysterectomy in cases of MAP using the 3D power Doppler was increased to 100%, 71.8%, and 50%, respectively, using the 3D MSV Doppler.
  
  
  CONCLUSIONS
  The 3D MSV Doppler is a useful adjunctive tool to the 3D power Doppler or color Doppler to refine the diagnosis of MAP.
authors.affiliation: Department of Ultrasound and Fetal Care Unit, Ain Shams University, Cairo, Egypt.
authors.forename: Alaa M
authors.initials: AM
authors.lastname: Abdel Moniem
authors.affiliation: Department of Obstetrics and Gynecology, Ain Shams University, Cairo, Egypt.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Ibrahim
authors.affiliation: Department of Obstetrics and Gynecology, Ain Shams University, Cairo, Egypt.
authors.forename: Sherif A
authors.initials: SA
authors.lastname: Akl
authors.affiliation: Department of Ultrasound and Fetal Care Unit, Ain Shams University, Cairo, Egypt.
authors.forename: Loay
authors.initials: L
authors.lastname: Aboul-Enen
authors.affiliation: Department of Obstetrics and Gynecology, Ain Shams University, Cairo, Egypt and Ahmadi Kuwait Oil (KOC) Company Hospital, Ahmadi, Kuwait.
authors.forename: Ibrahim A
authors.initials: IA
authors.lastname: Abdelazim
keywords: Doppler; Multislice view; morbid adherent placenta