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. 2023 Jun;161(3):920-926.
doi: 10.1002/ijgo.14595. Epub 2022 Dec 26.

Accuracy of ultrasound for the detection of placenta accreta spectrum in a universal screening population

Hanna Elise Baumann  1 , Laura Katharina Andrea Pawlik  1 , Irene Hoesli  2 , Andreas Schoetzau  3 , Heidrun Schoenberger  1 , Annkathrin Butenschoen  1 , Cécile Monod  1   2 , Gwendolin Manegold-Brauer  1
Affiliations

Accuracy of ultrasound for the detection of placenta accreta spectrum in a universal screening population

Hanna Elise Baumann et al. Int J Gynaecol Obstet. 2023 Jun.

Abstract

Objectives: The current study aimed to determine the sensitivity and specificity of ultrasound for the diagnosis of placenta accreta spectrum (PAS) in a universal screening population and assesses the added value of magnetic resonance imaging (MRI).

Methods: This retrospective analysis evaluated 5219 patients with singleton pregnancies who had a standardized ultrasound (US) examination in our unit and delivered at our institution between 2014 and 2019.

Results: A total of 181 (3.5%) of 5219 (100%) patients had a suspicion or diagnosis of PAS with US. The accuracy of US in detecting placenta increta/percreta showed a sensitivity of 100%, specificity of 99.9%, positive predictive value of 82.4%, and a negative predictive value of 100%. The diagnosis of all forms of PAS showed a sensitivity of 25.8%, specificity of 99.8%, positive predictive value of 80.8%, and a negative predictive value of 97.7%. MRI was concordant with US in 11 of 14 (78.5%) cases of severe forms of PAS and in three of 15 (20.0%) cases with placenta accreta.

Conclusion: A standardized US evaluation can be applied in a universal screening setting for the diagnosis of severe forms of PAS. MRI is a complementary examination in severe forms of PAS but seems of limited value to discriminate placenta accreta from placenta increta/percreta.

Keywords: magnetic resonance imaging; placenta accreta; placenta increta; placenta percreta; prenatal diagnosis; ultrasound.

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References

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