الفهرس 
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Abstract
SUMMARY
Morbidily adherent placenta is an abnormal implantation of the placenta into the uterine wall and has been used to describe placenta accrete, increta, and percreta.
Placenta accrete is considered a severe pregnancy complication that may be associated with massive and potentially life-threatening intrapartum and postpartum hemorrhage. It has become the leading cause of emergency hysterectomy.
Maternal morbidity had been reported to occur in up to 60% and mortality in up to 7% of women with placenta accrete.
The incidence of placenta accrete appears to be increasing, that increase is mainly the result of the increasing rate of cesarean delivery.
Placenta accrete is usually asymptomatic. profuse, life-threatening hemorrhage, peripartum hysterectomies, disseminated intravascular coagulopathy, adult respiratory distress syndrome, renal failure, unplanned surgery, and death are the most common complications.
Antenatal ultrasound is the technique of choice used to establish the diagnosis and guide clinical management.
Our aim was to assess the efficacy of use of the ultrasound scoring system in detection of pregnancy complicated by placenta accrete.
The study was performed on 75 pregnant women with prior cesarean deliveries with either placenta previa or low-lying anterior placenta. Sonographic parameters evaluated included: loss of the hypoechoic retroplacental demarcation line , interruption of uterine bladder interface, vascular lacunar spaces.
Confirmation was based on surgical findings of placental invasion. In the final analysis, 22 pregnant women (29.3%) underwent hysterectomy and had histologic confirmation of MAP; the remaining 53 (70.7%) complete separation of placenta has occurred.
According to the results, there was a significant relation between the loss of the hypoechoic retroplacental demarcation line, placental lacunar spaces and interruption of uterine bladder interface with placenta accrete. There was a significant relation between maternal age and the number of cesarean deliveries with the diagnosis of placenta accrete.