DOI: 10.36347/sjams.2019.v07i01.026

Pages: 142-148

Background: The placenta accreta spectrum (PAS) is a complex obstetric complication and is a relatively new disorder of placentation. Early diagnosis and intervention in these conditions can more readily enable the obstetrician to minimize the risks to mother and fetus. The study intends to compare the diagnostic efficacy of an ultra-sonographic score i.e. Placenta Accreta Index Score (PAI score) with Medical Resonance Imaging (MRI) to predict adherent placenta in cases of placenta previa with previous caesarean. Methods: It was a prospective, non-invasive, observational study of 80 pregnant females presenting at or above 28 weeks of gestation with placenta previa and history of one or more prior caesarean in department of Obstetrics and Gynecology, SMS Medical College, Jaipur. Written informed consent was taken. After thorough history and examination, they underwent both ultrasonography to find out PAI score (published in AJOG-2014) and MRI. They were followed till pregnancy was terminated and their feto-maternal outcomes were analyzed. Diagnostic efficacy of both modalities were compared. Result: In our study, on plotting ROC curve, the AUC (Area under Curve) was found 0.958 with a cut off value of >2. The Sensitivity, Specificity, PPV and NPV of PAI score were found to be 92.86%, 94.74%, 95.10% and 92.30% respectively and Sensitivity, Specificity, PPV and NPV of MRI were found to 66.67%, 100%, 100% and 73.08% respectively. Conclusion: Ultrasonography using PAI score is better as compared to MRI in prediction of adherent placenta.