The Role of Intracervical Lakes in Predicting Placenta Accreta Spectrum Disorders among Placenta Previa Patients: Cross sectional study

Ahmad Yousef, Heba Hassan; El Gelany, Saad; Tammam, Islam Yousry; Abdelgafar, Mohamed Hassan Mohamed

doi:10.21608/mjmr.2025.385746.1965

The Role of Intracervical Lakes in Predicting Placenta Accreta Spectrum Disorders among Placenta Previa Patients: Cross sectional study

Articles in Press

Document Type : Original Article

Authors

¹ Department Of Obstetrics and Gynaecology, Faculty of Medicine, Minia University

² Obstetrics and Gynecology, Faculty of Medicine – Minia University, Egypt.

³ Obstetrics and Gynecology Department, Faculty of medicine, Minia University,

⁴ Obstetrics and Gynecology, Faculty of Medicine , Minia university

10.21608/mjmr.2025.385746.1965

Abstract

Background: Placenta accreta spectrum disorder (PASD) describes an abnormal trophoblastic in vasion of part or all the placenta into the myometrium. This study introduces a new ultrasonic sign, intracervical blood lakes (ICL) which are defined as tortuous anechoic spaces within the cervix, which appear to be hypervascular on color Doppler. Aim: evaluate the diagnostic accuracy of a new ultrasound sign,“intracervical lakes”, in predicting presence and outcome of PAS disorders.

Subjects and Methods: This was a observational prospective study of 75women with placenta previa at ≥ 36 weeks of gestation, who were referred to the Obstetrics and Gynecology Department, Minia University Hospital, Minya Egypt from March 2024 to February 2025. The presence of ICL was evaluated by trans-vaginal ultrasound at 36 weeks of gestation. Follow-up of patients till delivery was done to explore the accuracy of this sign in predicting major intra and postpartum hemorrhage at the time of Cesarean section and the need for Cesarean hysterectomy (CH).

Results: Cervical lakes had the highest specificity of (98.1%) for detection of accretions with overall diagnostic accuracy of 100 % .

Conclusion: ICL are associated with PASD representing a marker of deep villus invasion, and its incorporation into ultrasound examination may increase the diagnostic accuracy for prediction of CH and major postpartum hemorrhage in women with placenta previa.

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