Correlation of Placenta Accreta Index with Surgical Findings on High Risk Patients For Placenta Accreta Spectrum In Tanta University Hospital

Abstract

Objectives: Placenta accreta spectrum “PAS” represents a major challenge due to the increasing number of pregnant women complicated by PAS and this is due to the increasing number of cesarean deliveries all over the world. Prenatal diagnosis of PAS decreases the risk of compliments at time of delivery. Two-dimensional (2D) grayscale ultrasound (US) and color Doppler US in the late second and third trimesters are the recommended imaging modalities to evaluate and diagnose PAS. Placenta Accreta Index (PAI) is a standardized approach to prenatal diagnosis of PAS incorporating clinical risk and ultrasound (US) findings suggestive of placental invasion by applying a value to the parameters of smallest sagittal myometrial thickness, lacunae, bridging vessels, number of cesarean deliveries and placental location.Study design: This cross sectional study.Patients and Methods: As conducted on 91 pregnant women selected from the Department of Obstetrics and Gynaecology, Tanta University Hospital (TUH) in their third trimester (from 28-36 gestational weeks) and were subsequently delivered at TUH from October 2023 to August 2024. This study was reported in accordance with the STARD guidelines (Standards for Reporting diagnostic accuracy studies).Results: The role of total score eout CS as a classifier to predictthe occurrence of accreta showed the following: sensitivity 83.1%, specificity 100%, PPV 100%, NPV 64.5%, and accuracy of 87.1%. The kappa was 0.698.The area under curve (AUC) as presented in the graph, was 0.932; its p-value was<0.001.Conclusions: (PAI) has good diagnostic efficacy and clinical utility for detection of PAS