• Henry Maynard, Stacy Zamudio, Eric Jauniaux, and Sally L Collins.
• Medical Sciences Division, University of Oxford, Oxford, UK.
• Int J Gynaecol Obstet. 2018 Mar 1; 140 (3): 332-337.

ObjectiveTo assess how a quantifiable measure of vascularity-i.e. abnormal confluence (Acon ) in the subplacental myometrium observed by three-dimensional power-Doppler ultrasonography-changes with different bladder volumes.MethodsIn a prospective observational study, women referred to a tertiary UK center with suspected PAS disorders were recruited between August 2016 and May 2017. The largest area of confluent three-dimensional power-Doppler signal (Acon ) at the uteroplacental interface was estimated under two bladder volumes differing by at least 200 mL.ResultsAcon was calculated for 14 women, of whom seven were subsequently found to have PAS disorders. For these seven women, log(Acon ) was significantly greater when measured with a filled bladder than when measured with an unfilled bladder (P<0.001).ConclusionObjective evidence was found for a quantifiable difference in vascularity in the myometrium with bladder volume among women with PAS disorders. This difference has sufficient magnitude to influence the potential of Acon as a diagnostic marker.© 2017 International Federation of Gynecology and Obstetrics.

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