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Abstract Background: The placenta normally adheres to the uterine wall; however, on occasion, it may infiltrate the wall so deeply that some or all of the placenta stays attached. Objective: The objective is to evaluate the accuracy of prenatal 3-dimensional power Doppler analysis of vascular and flow placental indices to predict the morbidly adherent placenta objectively. Methods: The data from 50 women who had placenta previa and underwent cesarean sections served as the basis for the analysis. In order to confirm gestational age, placental location, and findings suggestive of multiple pregnancies, all the women in the study underwent 2D trans-abdominal gray-scale imaging. These findings included the placenta appearing moth-eaten, the posterior uterine serosa-bladder interface being disrupted, and an exophytic mass invading the bladder. Then, using a 3-dimensional power Doppler display, two distinct sonographers with comparable measurement skills (supervisors and experts) evaluated years’ worth of scan data to ascertain whether patients suspected of having progressed invasive placentation. Results: Morbidly adherent placenta was detected in 18.0% (9/50) of the studied cases and underwent cesarean hysterectomies. Placenta accrete was detected in 55.6 % (5/9) and placenta percreta in 44.4%(4/9) with no placenta increta detected in the histopathology. Mean ±SD of blood loss was 1.6±0.7. Visceral injury (all were bladder injuries) and Blood transfusion were in 6.0% (3/50) and 22.0% (11/50) of the studied cases respectively. Conclusion: precise assessment of prenatal ultrasound using 3D and grayscale power The most effective method of detecting gestational acidemia preterm (MAP) is Doppler imaging. The current vascular flow index (VFI) can predict visceral damage, blood transfusion, and a morbidly adherent placenta with sufficient accuracy, enabling accurate antenatal risk assessment and perhaps leading to improved mother outcomes |