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Diagnostic Performance of Ultrasound in Placenta Accreta Spectrum associated with Placenta Previa: A Prospective Observational Study |
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Navneet Kaur Sooch, Amandeep Singh 1. Resident, Department of Radiodiagnosis and Imaging, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab, India. 2. Professor, Department of Radiodiagnosis and Imaging, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab, India. |
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Correspondence Address : Dr. Amandeep Singh, 469, East Mohan Nagar, Sultanwind Road, Amritsar-143001, Punjab, India. E-mail: dr.amancs@gmail.com |
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| ABSTRACT |  | ||||||
: 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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| Keywords : Abnormal placentation, Morbidly adherent placenta, Obstetric imaging, Placental invasion, Prenatal diagnosis, Uteroplacental interface | |||||||
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DOI and Others :
DOI: 10.7860/IJARS/2026/89057.3115
Date of Submission: Mar 16, 2026 Date of Peer Review: Apr 18, 2026 Date of Acceptance: May 21, 2026 Date of Publishing: Jul 01, 2026 AUTHOR DECLARATION: • Financial or Other Competing Interests: None • Was Ethics Committee Approval Obtained for this study? Yes • Was informed consent obtained from the subjects involved in the study? Yes • For any images presented appropriate consent has been obtained from the subjects. Yes PLAGIARISM CHECKING METHODS: • Plagiarism X-checker: Apr 13, 2026 • Manual Googling: May 14, 2026 • iThenticate Software: May 20, 2026 (14%) ETYMOLOGY: Author Origin EMENDATIONS: 7 |
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