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Routine screening for placenta accreta spectrum.

Amarnath Bhide1

  • 1St. George's Hospital, London, United Kingdom.

Best Practice & Research. Clinical Obstetrics & Gynaecology
|August 4, 2023
PubMed
Summary

Accurate screening for placenta accreta spectrum (PAS) is achievable, particularly in women with placenta previa and prior Cesarean deliveries. High-probability PAS cases require delivery at specialized centers for optimal outcomes.

Keywords:
Placenta accreta spectrumPlacenta previaScreening

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Area of Science:

  • Maternal-Fetal Medicine
  • Diagnostic Imaging in Obstetrics

Background:

  • Placenta accreta spectrum (PAS) poses significant maternal risks.
  • Accurate prenatal diagnosis is crucial for management planning.

Purpose of the Study:

  • To evaluate the accuracy of screening for placenta accreta spectrum (PAS).
  • To identify optimal screening strategies for PAS.

Main Methods:

  • Retrospective analysis of screening program data.
  • Assessment of sensitivity and specificity for PAS detection.
  • Focus on patient subgroups including those with placenta previa and prior Cesarean deliveries.

Main Results:

  • Screening demonstrates high accuracy (sensitivity and specificity >90-95%) for clinically significant PAS.
  • Screening is most productive in women with placenta previa and prior Cesarean deliveries.
  • Screening for PAS without placenta previa is less reliable, with reported false negatives.

Conclusions:

  • Clinically significant PAS can be accurately screened.
  • Women identified with high-probability PAS should be managed and delivered at specialized centers.
  • Referral to centers of excellence is recommended for screen-positive or uncertain cases.