Two- and three-dimensional power Doppler ultrasound in the follow-up of placenta accreta treated conservatively
Apport de l’échographique 2D/3D dans le suivi de l’élimination du résidu placentaire après traitement conservateur de placenta accreta
Résumé
OBJECTIVES:
To determinate the potential of 2D and 3D-ultrasound in the follow-up of patients with placenta accreta treated conservatively.
PATIENTS AND METHODS:
Seven patients with placenta accreta treated conservatively during June 2007 and September 2009 were included. The follow-up consisted in clinical examination and 2D/3D-ultrasound once a month. Criteria studied included clinical outcome, echogenicity at 2D-ultrasound, vascularisation at colour Doppler, Mean Grey at 3D-ultrasound and vascularisation, flow and perfusion index.
RESULTS:
Seven women with invasive placenta (3 placentas accreta and 2 percreta) were studied. The mean follow-up was 228 days [75-369]. Mean delay for complete elimination of residual placenta was 280 days [120-365]. The two main results were: presence of an increased anechogenicpart in residual placenta before complete resorption for all patients; a systematic and concomitant stop of genital haemorrhage and vascularisation at colour Doppler. High degrees of variability in parameters measured at 3D-ultrasound were observed between patients so that correlations with clinical outcome were found.
CONCLUSION:
Long and regular follow-up is essential after conservative management but the role of 3D-ultrasound compared to 2D-ultrasound was not demonstrated in this study.