Scoring Model for Prediction of Placenta Accreta Spectrum (PAS) in Early Pregnancy

Abstract

Aim: The objective of this prospective cohort study is to create a scoring model for prediction of placenta accreta in early pregnancy by two-dimensional ultrasound and color Doppler. Materials and Methods: In our study, we investigated 146 Patients at high risk of PAS using two dimensional and color Doppler ultrasound for findings suggestive of placenta accreta in early pregnancy. At time of delivery, diagnosis of placenta accreta was confirmed clinically. Results: Significant Doppler and 2D ultrasound findings for prediction for PAS in early pregnancy were; low implantation of the gestational sac, presence of placental lacunae and gestational sac or placenta overlapping uterine scar by 2D transvaginal ultrasound and Intraplacental dilated vessels by Doppler ultrasound. A scoring model for prediction of PAS in early pregnancy was created using these significant findings in addition to the number of previous CS deliveries. A cut-off point of 4.5 (out of 7.5 total score value) was used for prediction of cases at high risk of placenta accreta with sensitivity 77% and specificity 95%. Conclusion: A standardized risk assessment scoring model based on number of previous cesarean deliveries, 2Dultrasound and Doppler findings can predict women at highest risk for morbidly adherent placenta in early pregnancy with relatively high specificity.