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Current Women`s Health Reviews

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ISSN (Print): 1573-4048
ISSN (Online): 1875-6581

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Research Article

Sensitivity Level of Placenta Accreta Index (PAI) Score and Placenta Accreta Spectrum (PAS) Stage as Preoperative Diagnostic Tools for Placenta Accreta Spectrum Disorders (PASD) at Haji Adam Malik General Hospital Medan Indonesia

Author(s): Utari Purnama*, Makmur Sitepu, Deri Edianto, Sarma Nursani Lumbanraja, Yudha Sudewo, Roy Yustin Simanjuntak, Muara Panusunan Lubis and Melvin Nova Gunawanto Barus

Volume 18, Issue 3, 2022

Published on: 07 January, 2022

Article ID: e110821195560 Pages: 7

DOI: 10.2174/1573404817666210811130136

Price: $65

Abstract

Background: The incidence of Placenta Accreta Spectrum Disorders (PASD) has increased by 10-fold in 50 years along with the number of cesarean sections. Ultrasound examination using Placenta Accreta Index (PAI) score and Placenta Accreta Spectrum (PAS) stage as a predictor of PASD has been used worldwide at the antenatal screening. The high diagnostic value of these tools will help the physician to diagnose PASD early and minimize the rate of maternal neonatal mortality and morbidity.

Objectives: To evaluate the value of PAI score and PAS stage in diagnosing PASD.

Methods: This study is a diagnostic test study using the medical records of mothers who gave birth at Haji Adam Malik General Hospital Medan Indonesia between September 2017 to September 2020, who were diagnosed preoperatively as placenta previa suspected PASD through ultrasound examination using PAI score or PAS stage. The results of these two diagnostic tests were compared to clinical diagnostic criteria of PASD from The International Federation of Obstetrics and Gynecology (FIGO) with or without histopathological confirmation.

Results: Of the 177 placenta previa cases, there were 142 women with PASD (80.2%). The diagnostic values of PAI score with 4.6 as an optimal cut-off point were 75% sensitivity, 83% specificity, 94% positive predictive values (PPV), and 47% negative predictive values (NPV). The diagnostic values of the PAS stage were 90% sensitivity, 83%, specificity, 96% PPV, and 68% NPV.

Conclusion: PAI score and PAS stage have a diagnostic value that looks equally good when used as a diagnostic tool for PASD.

Keywords: Diagnostic tool, placenta accreta index score, placenta accreta spectrum disorders, placenta accreta spectrum stage, sensitivity, ultrasound.

[1]
American College of Obstetricians and Gynaecologists ACOG Committee Opinion. Placenta accreta No 266, Jan 2002. Int J Gynaecol Obstet 2002; 77: 77-8.
[http://dx.doi.org/10.1016/S0020-7292(02)80003-0]
[2]
Tantbirojn P, Crum CP, Parast MM. Pathophysiology of placenta creta: the role of decidua and extravillous trophoblast. Placenta 2008; 29(7): 639-45.
[http://dx.doi.org/10.1016/j.placenta.2008.04.008] [PMID: 18514815]
[3]
Dreux S, Salomon LJ, Muller F, Goffinet F, Oury JF, Sentilhes L. Second-trimester maternal serum markers and placenta accreta. Prenat Diagn 2012; 32(10): 1010-2.
[http://dx.doi.org/10.1002/pd.3932] [PMID: 22729439]
[4]
Balayla J, Bondarenko HD. Placenta accreta and the risk of adverse maternal and neonatal outcomes. J Perinat Med 2013; 41(2): 141-9.
[http://dx.doi.org/10.1515/jpm-2012-0219] [PMID: 23241664]
[5]
Jauniaux E, Ayres-de-Campos D, Langhoff-Roos J, Fox KA, Collins S. FIGO placenta accreta diagnosis and management expert consensus panel. FIGO classification for the clinical diagnosis of placenta accreta spectrum disorders. Int J Gynaecol Obstet 2019; 146(1): 20-4.
[http://dx.doi.org/10.1002/ijgo.12761] [PMID: 31173360]
[6]
Gielchinsky Y, Rojansky N, Fasouliotis SJ, Ezra Y. Placenta accreta- summary of 10 years: a survey of 310 cases. Placenta 2002; 23(2-3): 210-4.
[http://dx.doi.org/10.1053/plac.2001.0764] [PMID: 11945088]
[7]
Clark SL, Koonings PP, Phelan JP. Placenta previa/accreta and prior cesarean section. Obstet Gynecol 1985; 66(1): 89-92.
[PMID: 4011075]
[8]
Wax JR, Seiler A, Horowitz S, Ingardia CJ. Interpregnancy interval as a risk factor for placenta accreta. Conn Med 2000; 64(11): 659-61.
[PMID: 11125633]
[9]
Khong TY, Healy DL, McCloud PI. Pregnancies complicated by abnormally adherent placenta and sex ratio at birth. BMJ 1991; 302(6777): 625-6.
[http://dx.doi.org/10.1136/bmj.302.6777.625] [PMID: 2012876]
[10]
Hobson SR, Kingdom JC, Murji A, et al. No. 383-screening, diagnosis, and management of placenta accreta spectrum disorders. J Obstet Gynaecol Can 2019; 41(7): 1035-49.
[http://dx.doi.org/10.1016/j.jogc.2018.12.004] [PMID: 31227057]
[11]
Sakai Y, Ono M, Iizuka T, et al. Embryo transfer associated with hormone replacement therapy cycles using assisted reproductive technology increases placenta accreta spectrum. J Obstet Gynaecol Res 2019; 45(12): 2394-9.
[http://dx.doi.org/10.1111/jog.14111] [PMID: 31456311]
[12]
Wu S, Kocherginsky M, Hibbard JU. Abnormal placentation: twenty-year analysis. Am J Obstet Gynecol 2005; 192(5): 1458-61.
[http://dx.doi.org/10.1016/j.ajog.2004.12.074] [PMID: 15902137]
[13]
Armstrong CA, Harding S, Matthews T, Dickinson JE. Is placenta accreta catching up with us? Aust N Z J Obstet Gynaecol 2004; 44(3): 210-3.
[http://dx.doi.org/10.1111/j.1479-828X.2004.00208.x] [PMID: 15191444]
[14]
Placenta accreta No 266. Jan 2002. Int J Gynaecol Obstet 2002; 77: 77-8.
[http://dx.doi.org/10.1016/S0020-7292(02)80003-0]
[15]
Eller AG, Porter TF, Soisson P, Silver RM. Optimal management strategies for placenta accreta. BJOG 2009; 116(5): 648-54.
[http://dx.doi.org/10.1111/j.1471-0528.2008.02037.x] [PMID: 19191778]
[16]
Jauniaux E, Chantraine F, Silver RM, Langhoff-Roos J. FIGO consensus guidelines on placenta accreta spectrum disorders: Epidemiology. Int J Gynaecol Obstet 2018; 140(3): 265-73.
[http://dx.doi.org/10.1002/ijgo.12407] [PMID: 29405321]
[17]
Farquhar CM, Li Z, Lensen S, et al. Incidence, risk factors and perinatal outcomes for placenta accreta in Australia and New Zealand: a case-control study. BMJ Open 2017; 7(10): e017713.
[http://dx.doi.org/10.1136/bmjopen-2017-017713] [PMID: 28982832]
[18]
Rac MWF, Dashe JS, Wells CE, Moschos E, McIntire DD, Twickler DM. Ultrasound predictors of placental invasion: the Placenta Accreta Index. Am J Obstet Gynecol 2015; 212(3): 343.e1-7.
[http://dx.doi.org/10.1016/j.ajog.2014.10.022] [PMID: 25446658]
[19]
Finberg HJ, Williams JW. Placenta accreta: prospective sonographic diagnosis in patients with placenta previa and prior cesarean section. J Ultrasound Med 1992; 11(7): 333-43.
[http://dx.doi.org/10.7863/jum.1992.11.7.333] [PMID: 1522623]
[20]
Nelson T, Chang E, Goodier C, Mateus-Nino J. Validation of the Placenta Accreta Index (PAI): Improving the antenatal diagnosis of the morbidly adherent placenta. Am J Obstet Gynecol 2017; S133-4.
[http://dx.doi.org/10.1016/j.ajog.2016.11.114]
[21]
Cali G, Forlani F, Lees C, et al. Prenatal ultrasound staging system for placenta accreta spectrum disorders. Ultrasound Obstet Gynecol 2019; 53(6): 752-60.
[http://dx.doi.org/10.1002/uog.20246] [PMID: 30834661]
[22]
Happe SK, Yule CS, Spong CY, et al. Predicting placenta accreta spectrum: Validation of the placenta accreta index. J Ultrasound Med 2020; 9999: 1-10.
[http://dx.doi.org/10.1002/jum.15530] [PMID: 33058255]

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