ORIGINAL RESEARCH ARTICLE | June 16, 2025
Role of Transabdominal Color Doppler Ultrasound in the Evaluation for Antenatal Diagnosis of Placenta Accreta Spectrum Disorder in Women with Placenta Previa
Dr. Sonia Alam, Dr. Nasrin Akter, Dr. Tanzin Hossain, Dr. Arifa Akter Zahan Shoma, Dr. Arifa Akhter
Page no 199-207 |
https://doi.org/10.36348/sijog.2025.v08i06.001
Background: Placenta accreta is a severe pregnancy complication causing postpartum hemorrhage, bladder injury, and peripartum hysterectomy. Ultrasonography for antenatal diagnosis of PAS disorder has shown reduced maternal morbidity and death, making it crucial for management. This study determined the diagnostic value of ultrasound for the antenatal diagnosis of placenta accreta spectrum in women with placenta previa. Methods: This prospective observational study was conducted in the Department of Obstetrics and Gynaecology of Dhaka Medical College from June 2022 to May 2023. Forty pregnant women with placenta previa attending the outpatient section were included. Patients underwent ultrasound to assess the placenta and diagnose placenta accreta spectrum. Patients were followed until delivery. Pregnancy outcomes and perioperative diagnoses were observed or obtained from hospital records. Results: The mean age was 30.58 ± 3.82 years, with the majority of participants aged 30–40 years. About 52.5% had parity ≥3, 60% had cesarean section ≥2, and 20% had previous placenta previa. A significant link existed between parity (≥3), cesarean history (≥2), age (≥32 years), and preoperative PAS diagnosis. Ultrasonography showed that 72.5% had a placenta accreta spectrum, while intraoperative findings showed 80%. Among PAS cases, placenta increta (40.6%) and percreta (40.6%) were most common, followed by accreta (18.8%). In management, 87.5% underwent peripartum hysterectomy, and 21.5% had bladder injury repair. Based on perioperative identification, USG showed 84.38% sensitivity, 75.00% specificity, and 82.50% accuracy. Conclusion: Eighty percent of participants had placenta accreta syndrome. PAS was linked with age over thirty-two, higher parity, and multiple cesarean sections. Most needed peripartum hysterectomy, and one-fifth required bladder repair. Antenatal ultrasonography is a feasible diagnostic tool with sufficient accuracy that may reduce peripartum complications.
ORIGINAL RESEARCH ARTICLE | June 30, 2025
Prevalence and Risk of Accidental Haemorrhage among Women Diagnosed with Abruptio Placentae
Dr. Nafisa Jafreen, Dr. Jibon Chandro Das, Dr Ayesha Siddiqua, Dr. Shamsun Nahar, Dr. Shahana Ferdousi, Dr. Tania Rahman Mitul
Page no 208-214 |
https://doi.org/10.36348/sijog.2025.v08i06.002
Background: Accidental haemorrhage (abruptio placentae) is a significant obstetric complication contributing to maternal and perinatal morbidity and mortality. This study aimed to assess the prevalence and risk factors of accidental haemorrhage among women admitted to Dhaka Medical College Hospital. Methods: A prospective observational study was conducted in the Department of Obstetrics and Gynaecology, Dhaka Medical College Hospital, Dhaka, Bangladesh, from July 2002 to June 2003. This study included 50 cases of accidental haemorrhage among 9,078 obstetric admissions at Dhaka Medical College Hospital. Results: The incidence of accidental haemorrhage was 0.91%. Most patients were aged 20–29 years (68.0%) and from a low socioeconomic background (76.0%). Parity distribution revealed that 48.0% had parity of four or more. Clinically, 40.0% of patients presented with a pulse rate between 90–110 bpm, and the most common systolic blood pressure was 80 mmHg (40.0%). Anaemia was moderate in 40.0% of patients, and the majority (52.0%) had haemoglobin levels between 51–60%. A significant proportion (40.0%) received no antenatal care. Mixed-type haemorrhage was the most common presentation (50.0%), while Grade II haemorrhage predominated (44.0%). Preeclamptic toxaemia with pregnancy-induced hypertension was identified as the leading risk factor (50.0%). Conclusion: Accidental haemorrhage remains an important clinical challenge in obstetrics, particularly among multiparous women with low socioeconomic status and inadequate antenatal care. Early detection and comprehensive antenatal screening are essential to reduce morbidity and mitigate risk factors.