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Correlative Evaluation of the Abnormal Invasion of Placenta in Placenta Previa Using Ultrasonography, Colour Doppler and MRI and Maternal and Fetal Outcome at a Tertiary Care Center

Krishnaveni Avula. , S Swetha1 , Krishnaveni Avula2 , J Venkateshwar Reddy3 , Sushruth Kumar A4

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Indian Journal of Obstetrics and Gynecology 8(3):p 166-173, July–September 2020. | DOI: http://dx.doi.org/10.21088/ijog.2321.1636.8320.10

How Cite This Article:

S Swetha, Krishnaveni Avula, J Venkateshwar Reddy, Sushruth Kumar A Correlative Evaluation of the Abnormal Invasion of
Placenta in Placenta Previa Using Ultrasonography, Colour Doppler and MRI and Maternal and Fetal Outcome at a Tertiary Care
Center. Indian J Obstet Gynecol. 2020;8(3):166-173.

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Received : N/A         Accepted : N/A          Published : N/A

Abstract

Aim: To evaluate the abnormal invasion of placenta in placenta previa using Ultrasonography, Colour Doppler and MRI and to study the maternal and fetal outcome.


Introduction: Placenta previa in which the placenta is implanted either near or over the internal cervical os, presenting ahead of the leading pole of the fetus is seen in 0.4-0.5% of all labours. Patients are at increasedrisk of abortions and premature deliveries, fetalmal-presentations, Caesarean sections, intrapartum haemorrhage, peripartum hysterectomy, birth asphyxia and maternal and perinatal morbidity and mortality. This study was conducted on 50 pregnant mothers who were diagnosed to have placenta previa.


Material and Methodology: A prospective study was done at Gandhi Hospital between October 2015 and 2016 on 50 pregnant women with diagnosed placenta previa after written informed consent. History of
period of gestation, previous uterine manipulations and surgeries, complaints like bleeding per vaginum, complications during present and past pregnancy and particulars like post partum period, fetaloutcomes like maturity, birthweight and perinatal morbidity and mortality were studied and entered in a Proforma. Blood Investigations like CBP, Renal function tests, Ultrasonography, Colour Doppler and MRI
were done. The data of imaging techniques was compared to the intraoperative data using t-test.


Results: Three quarters were unbooked cases. 46% presented with bleeding per vaginum. The incidence of placenta previa was highest
in women with third pregnancy and in those withprevious Caesarean section.On Ultrasonography, 64% had major and 26% had
minor Placenta previa. On Colour Doppler, 76% did not have invasion of
placenta which was confirmed with MRI. Caesarean section was done in 58%, andHysterectomy in 16%. 18% had adhesion between uterus and bladder in 18%. Placenta could not be separated in 14%.
B-Lynch sutures, Devascularization procedures like bilateral uterine artery ligation and bilateral internal Iliac artery ligation were needed. Bladder was repaired in 10%. Uterine wall was excised in 4%
of the cases. Complications included Hemorrhage in 20%, Hypovolaemic shock in 12%, bladder injury in 8%, and Renal failure in 2%. 8% required ventilatory support. The maternal mortality was 2%. Preterm babies constituted 58%. 26% of babies died.

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Cite this article

S Swetha, Krishnaveni Avula, J Venkateshwar Reddy, Sushruth Kumar A Correlative Evaluation of the Abnormal Invasion of
Placenta in Placenta Previa Using Ultrasonography, Colour Doppler and MRI and Maternal and Fetal Outcome at a Tertiary Care
Center. Indian J Obstet Gynecol. 2020;8(3):166-173.

Licence:



Received Accepted Published
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DOI: http://dx.doi.org/10.21088/ijog.2321.1636.8320.10

Keywords

Placenta previa; Adherent placenta; Ultrasound; Colour Doppler; MRI; Haemorrhage; Maternal outcome; fetal outcome.

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