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Year :2026
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Month :
July-August
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Volume :
15
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Issue :
4
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Page :
RO05 - RO09
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Diagnostic Performance of Ultrasound in Placenta Accreta Spectrum associated with Placenta Previa: A Prospective Observational Study
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Correspondence Address :
Navneet Kaur Sooch, Amandeep Singh,
Dr. Amandeep Singh,
469, East Mohan Nagar, Sultanwind Road, Amritsar-143001, Punjab, India.
E-mail: dr.amancs@gmail.com
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Introduction: Introduction: Placenta Accreta Spectrum (PAS) represents a serious obstetric complication characterised by abnormal placental adherence to the uterine wall, resulting in severe maternal morbidity due to massive haemorrhage, need for hysterectomy, and increased perioperative complications. Ultrasonography, particularly with colour Doppler, remains the primary imaging modality for evaluating suspected PAS.
Aim: To evaluate the diagnostic performance of ultrasonography in detecting PAS in patients with placenta previa.
Materials and Methods: This prospective observational study was conducted in the Department of Radiodiagnosis and Imaging, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab, India, from July 2024 to December 2025. A total of 65 pregnant women with placenta previa or low-lying placenta and a history of at least one previous caesarean section, with gestational age greater than 20 weeks, were included. Ultrasound examinations were performed using a Voluson E8 system with a convex probe (2-5 MHz). Grey-scale and colour Doppler imaging were used to evaluate sonographic parameters, including intraplacental lacunae, myometrial thickness, loss of retroplacental clear space, bladder line interruption, and bridging vessels. Placenta Accreta Index (PAI) scores were also calculated to assess their diagnostic value. Diagnostic accuracy was determined by calculating sensitivity, specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV), and overall accuracy.
Results: The mean age of the study population was 30.1±5.5 years. The mean gestational age was 31.0±3.9 weeks. PAS was confirmed in 26 out of 65 cases (40%). Higher PAI scores were significantly associated with PAS, with a mean score of 7.7±1.5 in PAS cases compared to 5.3±1.2 in non PAS cases (p-value <0.001). A significant association was observed between PAS and the number of previous caesarean sections, lacunar grade, myometrial thickness, and presence of bridging vessels (p-value <0.001). Ultrasonography demonstrated a sensitivity of 96.2%, specificity of 89.7%, PPV of 86.2%, and NPV of 97.2%. The area under the ROC curve was 0.91, indicating excellent diagnostic performance.
Conclusion: Ultrasonography is a highly reliable modality for antenatal detection of PAS in high-risk pregnancies.
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