الفهرس 
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Abstract
Morbidily adherent placenta is an abnormal implantation of the placenta into the uterine wall and has been used to describe placenta accreta, increta, and percreta.
Placenta accreta 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 accreta.
The incidence of placenta accreta appears to be increasing, that increase is mainly the result of the increasing rate of cesarean delivery.
Placenta accreta 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 model in detection of pregnancy complicated by placenta accreta.
The study was performed on 105 pregnant women with prior cesarean deliveries with either placenta previa or low-lying anterior placenta. Sonographic parameters evaluated included: location of placenta, loss of the retroplacental space, irregularity of uterine bladder interface, thinning of uterine bladder interface, myometrial thickness, lacunar spaces, bridging vessels, utero-vesical and sub-placental hypervascularity, placental lacunae feeder vessels, placental bulge and focal exophytic mass.
Confirmation was based on surgical findings and histologic evidence of placental invasion. In the final analysis, 45 pregnant women (42.8%) underwent hysterectomy and had histologic confirmation of MAP; the remaining 60 (57.2%) complete separation of placenta has occurred.
According to the results, there was a significant relation between the loss of retroplacental space, the smallest myometrial thickness, placental lacunar spaces and utero-vesical hypervascularity with the histopathological accreta. There was no significant relation between the irregularity and thinning of uterine bladder interface, placental bulge, focal exophytic mass, maternal age and the number of cesarean deliveries with the histopathological diagnosis of placenta accreta.