DIAGNOSTIC ACCURACY OF ULTRASOUND IN DETECTING PLACENTA ACCRETA USING INTRAOPERATIVE FINDINGS AS THE GOLD STANDARD

Abstract

Objective: To determine the diagnostic accuracy of ultrasound in detecting placenta accreta, with the aim of facilitating early diagnosis, appropriate management, and reduction of maternal morbidity.

Study Design: Cross-sectional study.

Study Setting: Department of Obstetrics and Gynecology

Study Duration: Six Months (July’24 to January’25  )

Methodology: total of 205 high-risk pregnant women, aged 20–40 years, suspected of placenta accreta were included in the study. Exclusion criteria were primigravida, unintentional bleeding, gestational age under 28 weeks, and posterior placenta location. To evaluate the varying utero-placental vascularity, a Color Doppler scan was conducted. If the placenta was easily removed without bleeding during surgery, it was considered normal; however, if the placenta was difficult to remove and there was considerable bleeding (≥1000cc), it was deemed placenta accreta. Ultrasound findings were then compared with intraoperative results to evaluate the diagnostic accuracy of ultrasonography.

Results: Using intraoperative findings as the gold standard, the overall sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of ultrasonography for placenta accreta diagnosis were 90.43%, 93.33%, 94.55%, 88.42%, and 91.70%, respectively.

Conclusion: Ultrasonography is a sensitive and accurate modality for placenta accreta identification. It has significantly increased our capacity to identify the condition and, as a result of its precise diagnosis, has also improved patient care.