From the Research
Ultrasound is the preferred method for uterine wall analysis during pregnancy due to its safety, accessibility, and real-time imaging capabilities. It allows clinicians to evaluate the uterine wall thickness, detect abnormalities like placenta accreta or uterine rupture, and monitor changes throughout pregnancy without radiation exposure. The main advantages of ultrasound include its non-invasive nature, absence of ionizing radiation, widespread availability, cost-effectiveness, and ability to provide real-time assessment 1.
Advantages of Ultrasound
- Non-invasive nature
- Absence of ionizing radiation
- Widespread availability
- Cost-effectiveness
- Ability to provide real-time assessment
- Allows for the evaluation of uterine wall thickness and detection of abnormalities like placenta accreta or uterine rupture 2
Limitations of Ultrasound
- Operator dependency requiring skilled technicians
- Reduced image quality in obese patients
- Limited visualization of posterior uterine wall structures
- Difficulty distinguishing between certain tissue types
- Inability to provide the detailed tissue characterization that MRI offers 3
However, ultrasound remains the first-line imaging modality for routine pregnancy monitoring, and MRI may be recommended as a complementary technique when ultrasound findings are inconclusive or when more detailed assessment of the uterine wall is required, particularly in cases of suspected placental invasion disorders or uterine dehiscence 2, 3. The study by 2 found that ultrasound imaging is the mainstay of screening for placenta accreta, with a sensitivity of 100%, and that MRI appears to be complementary to ultrasonography, especially when there are few ultrasound signs.
In terms of specific techniques, standard ultrasound examinations typically include transabdominal scans using 3-5 MHz probes, with transvaginal approaches (using 5-10 MHz probes) offering better resolution in early pregnancy 4. The features of greatest sensitivity on ultrasonography were intraplacental lacunae and loss of the normal retroplacental clear space, while increased vascularization in the uterine serosa-bladder wall interface and vascularization perpendicular to the uterine wall had the best positive predictive value 2.