{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T12:25:06Z","timestamp":1773923106800,"version":"3.50.1"},"reference-count":41,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2013,3,25]],"date-time":"2013-03-25T00:00:00Z","timestamp":1364169600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2013,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To evaluate the diagnostic accuracy of two\u2010dimensional (<jats:styled-content style=\"fixed-case\">2D<\/jats:styled-content>) gray\u2010scale and color Doppler and three\u2010dimensional (<jats:styled-content style=\"fixed-case\">3D<\/jats:styled-content>) power Doppler sonographic criteria for morbidly adherent placenta (<jats:styled-content style=\"fixed-case\">MAP<\/jats:styled-content>), and to identify criteria to help distinguish placenta accreta from placenta percreta.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We enrolled 187 patients with placenta previa and history of uterine surgery and performed transabdominal and transvaginal ultrasound examination for early detection of <jats:styled-content style=\"fixed-case\">MAP<\/jats:styled-content>. With <jats:styled-content style=\"fixed-case\">2D<\/jats:styled-content> gray\u2010scale transabdominal and transvaginal ultrasonography, we investigated loss\/irregularity of the echolucent area between the uterus and the placenta (\u2018clear space\u2019), thinning or interruption of the hyperechoic interface between the uterine serosa and the bladder wall and the presence of turbulent placental lacunae with high\u2010velocity flow (&gt;15\u2009cm\/s). Using transabdominal <jats:styled-content style=\"fixed-case\">3D<\/jats:styled-content> power Doppler, we evaluated the hypervascularity of the uterine serosa\u2013bladder wall interface and irregular intraplacental vascularization. Ultrasound findings were reviewed against the final diagnosis made during Cesarean section (<jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">MAP<\/jats:styled-content> was detected on <jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content> in 41 patients. All of them had an anterior placenta previa (34 major and seven minor) and had undergone at least one previous <jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content>. The evaluated sonographic criteria showed good diagnostic performance; in <jats:styled-content style=\"fixed-case\">MAP<\/jats:styled-content> patients at least two out of five criteria were detected, with at most one of the criteria present in patients without MAP. Loss\/irregularity of clear space used as a single criterion was responsible for the most false positives, demonstrating a low positive predictive value. Irregular intraplacental vascularization with tortuous confluent vessels affecting the entire width of the placenta, and hypervascularity of the entire uterine serosa\u2013bladder wall interface, were only detected, on <jats:styled-content style=\"fixed-case\">3D<\/jats:styled-content> power Doppler, in cases of placenta percreta.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The reviewed ultrasound criteria may be useful for the prenatal diagnosis of <jats:styled-content style=\"fixed-case\">MAP<\/jats:styled-content> and to differentiate between placenta accreta and placenta percreta; <jats:styled-content style=\"fixed-case\">3D<\/jats:styled-content> power Doppler techniques were an important aid in the diagnosis. Copyright \u00a9 2013 ISUOG. Published by John Wiley &amp; Sons, Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.12385","type":"journal-article","created":{"date-parts":[[2013,1,3]],"date-time":"2013-01-03T10:52:55Z","timestamp":1357210375000},"page":"406-412","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":161,"title":["Morbidly adherent placenta: evaluation of ultrasound diagnostic criteria and differentiation of placenta accreta from percreta"],"prefix":"10.1002","volume":"41","author":[{"given":"G.","family":"Cal\u00ec","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology ARNAS Civico, Di Cristina e Benfratelli  Palermo Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L.","family":"Giambanco","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology ARNAS Civico, Di Cristina e Benfratelli  Palermo 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