Apport de l'échographique 2D/3D dans le suivi de l'élimination du résidu placentaire après traitement conservateur de placenta accreta

Patients and methods. - Seven patients with placenta accreta treated conservatively duringJune 2007 and September 2009 were included. The follow-up consisted in clinical examinationand 2D/3D-ultrasound once a month. Criteria studied included clinical outcome, echogenicityat 2D-ultrasound, vascularisation at colour Doppler, Mean Grey at 3D-ultrasound and vasculari-sation, flow and perfusion index.

Objectives. - To determinate the potential of 2D and 3D-ultrasound in the follow-up of patientswith placenta accreta treated conservatively.

Results. - Seven women with invasive placenta (3 placentas accreta and 2 percreta) were stu-died. The mean follow-up was 228 days [75-369]. Mean delay for complete elimination ofresidual placenta was 280 days [120-365]. The two main results were: presence of an increasedanechogenicpart in residual placenta before complete resorption for all patients; a systema-tic and concomitant stop of genital haemorrhage and vascularisation at colour Doppler. Highdegrees of variability in parameters measured at 3D-ultrasound were observed between patientsso that correlations with clinical outcome were found.

Conclusion. -Long and regular follow-up is essential after conservative management but therole of 3D-ultrasound compared to 2D-ultrasound was not demonstrated in this study.