Abstract

VELGARA MALDONADO, M; GONZALEZ RUIZ DIAZ, MA  and  HOSPITAL DE CLINICAS. SAN LORENZO. FACULTAD DE CIENCIAS MEDICAS. UNIVERSIDAD NACIONAL DE ASUNCION. PARAGUAY. Cátedra de Ginecología y Obstetricia. Unidad de Alto Riesgo Obstétrico. Dpto. de Ecografía y Medicina Perinatal. Utility of placental acretism color Doppler ultrasound diagnossis at the ‘Hospital de Clínicas’. An. Fac. Cienc. Méd. (Asunción) [online]. 2012, vol.45, n.2, pp.15-24. ISSN 1816-8949.

ABSTRACT Introduction: The acretism pathology and his different levels are associate to previous placental and previous cesarean section scar, wich is a situation that keeps increasing in our service. The prenatal diagnosis is fundamental to programme and qualified attention and to avoid maternal death. Objective: To value the practicality of the ultrasound diagnosis in gray scale and Doppler Map on Prenatal diagnosis to presume the placental acretismo compared with quirurgicals finding. Methods and material: It is an long-term cohort research. Were included pregnant women on their third trimester with risk of placental acretism in prevous placenta. Form February 2009 to august 2010 at the "Centro Materno-Infantil del Hospital de Clínicas FCM-UNA.", Cáthedra of Ginecology and Obstetrics has place. All the pacients went through Ultrasound obstetric in third trimester adding color Doppler Map.For the ultrasound and color Doppler protocol was on the research of acretism symptoms, counting with published items made by Finberg HJ and others. The research was made trough abdominal and transvaginal way, evaluating the miometrial wall, the serosa and the vesicle wall. Results: From 30 examinated pacients turno ut to be 10 pacients (33%) whom were diagnosed with high probabilities of acretism. The concordance to the gray scale ultrasound and the color Doppler map was 90%. The complementary analysis with color Doppler showed also percretism symptoms in 5 pacients (55, 5%) from 9 pacients comfirmed at the quirurgical act. Conclusions: The gray scale US, along with the color Doppler Map, it is a high value tool for the acretismo level in Placenta Previa and in pacients with previous scar records. Keywords: previous placental, acretismo, gestation, previous cesarean scar.

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