Diagnostic Value of Transvaginal Ultrasound in Pernicious Placenta Previa with Placenta Accrete
HU Xueyang
ZHAO Yue
MA Xinran
ZHANG Rui
WANG Zhibao
GAO Jing
Abstract：Objective To investigate the diagnostic value of transvaginal ultrasound in pernicious placenta previa(PPP)with placenta accreta.Methods A total of 116 patients who underwent cesarean section and were diagnosed with PPP at Baoding No.2 Hospital from April 2017 to July 2022 were selected as the study subjects.All received transvaginal ultrasound to determine placenta accreta.Based on intraoperative findings and postoperative pathological results as the gold standard,patients were divided into a placenta accreta group(n=73)and a non-placenta accreta group(n=43).The diagnostic efficacy of transabdominal ultrasound and transvaginal ultrasound for PPP with placenta accreta was analyzed using receiver operating characteristic(ROC)curves.Results Among the 116 patients,73(62.93%)had placenta accreta,including 28(24.14%)with placenta accreta,33(28.45%)with placenta increta,and 12(10.34%)with placenta percreta;43(37.07%)patients had no placenta accreta.The differences in parity and number of previous cesarean deliveries between the placenta accreta group and the non-placenta accreta group were statistically significant(P<0.05).Using the gold standard as reference,the sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of transabdominal ultrasound for diagnosing PPP with placenta accreta were 84.93%,74.42%,81.03%,84.93%,and 74.42%,respectively(Kappa=0.594).The corresponding values for transvaginal ultrasound were 89.04%,90.70%,89.66%,94.20%,and 82.98%(Kappa=0.782).The specificity of transvaginal ultrasound was higher than that of transabdominal ultrasound(P<0.05).ROC curve analysis showed that the areas under the curve for transabdominal ultrasound and transvaginal ultrasound were 0.797(95%CI:0.712-0.866)and 0.899(95%CI:0.829-0.947),respectively,with a statistically significant difference(Z=3.311,P<0.001).Analysis of ultrasound images from 65 patients with PPP and placenta accreta diagnosed consistently by both transvaginal ultrasound and the gold standard revealed that all cases showed interruption(or disappearance)and thinning of the myometrium at the placental attachment site;78.46%(51/65)showed abnormally abundant blood flow signals behind the placenta;and 81.54%(53/65)showed an ill-defined retroplacental clear space.Conclusion Transvaginal ultrasound has good diagnostic value in patients with PPP and placenta accreta and can be used as an auxiliary method for prenatal diagnosis in clinical practice.
Keywords：pernicious placenta previaplacenta accretatransvaginal ultrasounddiagnosis
Publication Date：2026-03-20
Online Publishing Date：2026-03-26(First online date of this platform, not the publication date of the document)
Pages：6( 454-459 )