Placenta Accreta Spectrum Clinical Trial
Official title:
Accuracy of Placenta Accreta Index in Diagnosing Placenta Accreta Spectrum: A Prospective Study
The placenta accreta spectrum (PAS) which includes accreta, increta, and percreta represents
a significant obstetric challenge. PAS complicates as many as 1 per 500 pregnancies and this
risk is increased with prior cesarean deliveries. Antenatal diagnosis of PAS allows for
multidisciplinary planning and delivery before the onset of labor and/or vaginal bleeding.
This approach has reduced maternal morbidity rates, including less blood loss, fewer
transfusion requirements and, intraoperative urologic injuries as well as improve fetal
outcome.
Ultrasound evaluation, with grayscale and color Doppler imaging, is the recommended
first-line modality for diagnosing PAS. Grayscale ultrasound features suggestive of placenta
accreta include an inability to visualize the normal retroplacental clear zone, irregularity,
and attenuation of the uterine-bladder interface, retroplacental myometrial thickness,
presence of intraplacental lacunar spaces, and bridging vessels between the placenta and
bladder wall when using color Doppler.
The placenta accreta index (PAI) score (a nine-point score) was proposed in 2015 to predict
PAS based on US parameters in a high-risk population by retrospective data analysis. The
probability of histological invasion was found to increase with increasing the PAI score.
This study aimed to prospectively evaluate the diagnostic performance of the PAI in the
prediction of PAS in relation to histopathological findings.
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