The Added Diagnostic Value of Transvaginal Ultrasound to Transabdominal Ultrasound in Detection and Assessment of Placenta Previa
Journal Title: Journal of Medical Science And clinical Research - Year 2018, Vol 6, Issue 1
Abstract
Aim: To evaluate the added diagnostic value of the transvaginal ultrasound (TVUS) to transabdominal ultrasound (TAUS) in the detection and evaluation of placenta praevia (PP). Methods: This study was carried out on 46 pregnant women during the second trimester, the third trimester or both, over two year’s duration. The study group was divided into two main groups: a- The pathological group including 8 pregnant women who were diagnosed to have abnormal relation of their placentae to the internal os in the 2nd trimester. Only two of them were diagnosed to have PP in the third trimester and the remaining six were excluded from the study b- The control group which included 20 pregnant women who were diagnosed to have normal relation of their placentae to the internal os by both TAUS and TVUS. The findings of both techniques were compared with each other and with the operative results after cesarean sections (CS). Statistical analysis was carried out using Chi-square test, Fisher’s Exact or Monte Carlo correction & Student t-test. Results: TAUS correctly diagnosed 12/12 (100%) cases of PP totalis, 2/2 cases of PP near totalis, 3/4 cases of PP marginalis. While it overestimated one case of PP marginalis as PP totalis, in addition to false positive diagnosis of PP in two cases who were falsely diagnosed as PP marginalis in one case and low lying placenta in another case. Both cases were diagnosed as normal by TVUS and operative room data. TAUS succeeded in negation of PP in all 20 (100%) control cases. It showed 100%, 90%, 90% and 100% sensitivity, specificity, positive predictive value and negative predictive values respectively. TVUS showed true positive diagnosis of PP in 100% of cases, and negated PP in all 20 control pregnant women (true negative diagnosis). It correctly excluded the false positive diagnosis in two cases as low lying placenta and PP marginalis suggested by TAUS. It also corrected another overestimated diagnosis of PP totalis in a case of PP marginalis by TAUS. It showed 100% diagnostic accuracy, sensitivity, specificity, positive predictive value & negative predictive value. Conclusion: Diagnosis of PP should not be established except on the 3rd trimester. TAUS has higher incidence of false positive diagnosis of PP in comparison to TVUS. TVUS is a valuable procedure to compliment TAUS in the evaluation of patients with suspected PP
Authors and Affiliations
Ola Mohamed Darwish
Keywords
Related Articles
- EP ID EP478397
- DOI -
- Views 67
- Downloads 0
Epidermal Inclusion Cyst of the Breast
Epidermal inclusion cysts are uncommon in the breast, but the consequences can be severe when these cysts occur in the breast parenchyma. Here we report one such case. The patient was 45 yrs old women with 3*2 cms mobile...
Psychiatric Co-Morbidities in Individuals with Alcohol Dependence: A Prospective Observational Study
Introduction: Alcohol consumption has been on rise in developing as well as developed world. It is not only associated with pathologies like Peripheral Vascular disease, avascular necrosis of bones, cirrhosis of liver an...
Clinical Study of Sterile Collagen Particles (Biofil) in the Management of Chronic Non Healing Ulcers
Introduction: Patients who are suffering from non healing ulcers may lead into a significant problems and prolonged stress. Pain and discomfort are the main complaint of chronic non healing ulcer patients1 . Pain may be...
PET scan Misleads to Diagnosis but Leads to Correct Operative Approach
A 67 year old female presented with high grade fever and abdominal pain since one week. Pain in abdomen was predominantly in the left lumbar region. She also had anorexia and weight loss. Patient had diabetes mellitus si...
Ruptured Sinus of Valsalva Aneurysm: An Unusual Cause of Pleural Effusion -Case Report
Sinus of Valsalva aneurysm (SVA) is one of the rare cardiac anomalies described in the literatures and ruptured sinus of valsalva (RSOV) is a form of left-to- right shunt .The presentation may range from dyspnea to cardi...