الفهرس 
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Abstract
Introduction: Morbidly adherent placenta (MAP) is probably the most challenging problem in modern obstetrics and remains the leading cause of maternal and neonatal mortality and morbidity. The clinical suspicious of MAP by placenta previa with previous CS scar/s is not sufficient for diagnosis as the higher percent of these cases had no accretion. Pathophysiologic evidence revealed that the more important is the presence of scar defect that predispose to abnormal placental invasion and adhesions. The aim of work: Test the sensitivity and accuracy of three-dimensional (3D) Color Power Doppler in the antenatal diagnosis of morbidly adherent placenta (MAP), and compare its diagnostic performance with two-dimensional (2D) ultrasonography, and color Doppler in women with risk factor/s. Attempt to add new criteria help in both the diagnosis and differentiation between MAP variants accreta, increta and percreta using three-dimensional (3D) color Power Doppler. Research Plan: Our study included 120 case of placenta previa with previous CS scar/s, all of them were evaluated by the three techniques of imaging and subdivided according to the imaging results and the scoring system into 5 groups: - no accreta, accreta, increta, focal percreta and diffuse percreta. Comparing preoperative with intraoperative diagnosis placenta previa without accreta was made in (n= 25, 20.8 %) and were mainly with placenta previa laterals which described as placental edge on the scar, while MAP and its variants (accreta ,increta and percreta) were confirmed in 95 patients, where placenta accreta (n= 13, 10.8 %), placenta increta (n=24 , 20%), focal percreta (n=24, 20%)and diffuse percreta (n=34, 28.3%). Results: Conclusion : Good resolution machine can diagnose MAP with little difference between 2D, color Doppler and 3D power Doppler, but the complementary use of them in a scoring system decrease the false positive and false negative cases, that could be more simplified and standardized and fulfill all criteria of diagnosis and differentiation between MAP variants, with better preparations and management of cases in attempt to decrease maternal morbidity and mortality. According to the proper diagnosis we could design a plane of management that helps us to preserve the uterus and decrease vascular injuries through uterus and internal iliac artery sparing vascular procedures.