الفهرس 
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Abstract
Placenta accreta is a condition of abnormal placental implantation in which the placental tissue invades beyond the decidua basalis. It may invade into or even through the myometrium and adjacent organs, such as the urinary bladder. It is a major cause of obstetric hemorrhage and complication leading to significant maternal morbidity and mortality. The incidence of placenta accreta has increased with the rising number of cesarean deliveries. Current estimates indicate a 25% to 50% incidence of placenta accreta in patients with placenta previa and prior cesarean delivery. A prospective comparative study design was used to compare the role of three-dimensional power Doppler ultrasonography in the antenatal diagnosis of placenta accreta with two-dimensional and color Doppler ultrasonography. This study was carried out on 50 women pregnant females at the Department of Obstetrics and Gynecology, Tanta University Hospitals. Including, patients with placenta previa and previous one or more ceserian section at gestational age from 28 weeks to 36weeks, and the diagnosis of placenta previa confirmed using all diagnostic techniques (gray scale, color Doppler, and 3D power Doppler) and full availability of delivery information. Excluding, haemodynamical unstable patient due to severe vaginal bleeding. Each participant was subjected to: verbal and written consent, history: detailed history taking from each patient regarding age, parity, with special reference to present, past, and obstetric history, examination: including, pulse, blood pressure recording, routine investigation :complete blood picture ,Rh typing, Investigational studies :three dimensional power Doppler ultrasonography, two dimensional and color Doppler ultrasonography. The study found that the age of our patients ranged from 20 to 41 years old, at the time of diagnosis with mean age 30.18 years, more than half (62.0%) of This study participants were from rural area, and most of them (62.0%) were housewives. The mean number of gravidities of This study participants was 4.14, the mean number of parities was 2.30, the mean number of CS was 2.44, the mean number of abortions was 0.70. During labor, 48.0 % of study participants had placenta accreta while 52.0% of them had no placenta accreta. According to the final surgical and pathological reports, Gray scale US had sensitivity 87.5 % to predict placenta accreta, specificity 84.6 %, positive predictive value 84.0 %, negative predictive value 88.0 %, accuracy 86.0 %. 2D color Doppler US had sensitivity 91.7 % to predict placenta accreta, specificity 96.2 %, positive predictive value 95.7 %, negative predictive value 92.6 %, accuracy 94.0 %. 3D Doppler US had sensitivity 95.8% to predict placenta accreta, specificity 88.5%, positive predictive value 88.5%, negative predictive value 95.8%, accuracy 92.0%. 3D Doppler US was the most sensitive to predict placenta accreta, while 2D color doppler US was the most specific and accurate than gray scale US and 3D Doppler.