Evaluation of the diagnostic accuracy of a combination of first-trimester ultrasound and maternal demographic characteristics for detecting abnormally invasive placenta

Eur J Obstet Gynecol Reprod Biol. 2022 Jan:268:1-6. doi: 10.1016/j.ejogrb.2021.11.006. Epub 2021 Nov 9.

Abstract

Objective: The aim of present study was to evaluate the diagnostic accuracy of using a combination of a first-trimester ultrasound and the maternal demographic characteristics in detecting abnormally invasive placenta (AIP).

Study design: This prospective case-control study comprised 540 women who meet the inclusion criteria and who were included in the final analysis. Patients scored points based on a range between 0 and 13 for the ultrasonographic and clinical findings within first trimester. The primary outcome of the study was whether placenta accreta, increta, and percreta could be predicted early in pregnancy.

Results: The cutoff value of 5.5 provided a sensitivity of 100% and a specificity of 88% and the diagnostic odds ratio (DOR at 95% confidence interval [CI]) was 208 (12-3543), at 95%CI) was 0, and the positive likelihood ratio (LR + at 95%CI) was 8.25 for placenta percreta. The cutoff value of 6.5 provided a sensitivity of 92% and a specificity of 93% and DOR at 95%CI was 201.5 (25.5-1583.1), LR- at 95%CI was 0.08, and LR + at 95%CI was 15.32 for placenta percreta. The cutoff value of 4.5 provided a sensitivity of 100% and a specificity of 90% and DOR at 95%CI was 615 (37-10207), LR- at 95%CI was 0, and LR + at 95%CI was 11.7 for accreta and increta, respectively. The cutoff value of 5.5 provided a sensitivity of 87% and a specificity of 92% and DOR at 95%CI was 86.8 (28.9-260.8), LR- at 95%CI was 0.14, and LR + at 95%CI was 11.7 for placenta accreta and increta, respectively.

Conclusion: The results of the present study indicated that this novel scoring provided high diagnostic accuracy for detecting all types of AIP during the first trimester.

Keywords: Abnormally invasive placenta; Increta; Percreta; Placenta accreta first-trimester diagnosis; Ultrasound.

Publication types

  • Review

MeSH terms

  • Case-Control Studies
  • Demography
  • Female
  • Humans
  • Placenta / diagnostic imaging
  • Placenta Accreta* / diagnostic imaging
  • Pregnancy
  • Pregnancy Trimester, First
  • Ultrasonography, Prenatal