Correlation between Early and Late Ultrasound Scan for Diagnosis of Placenta Accreta Spectrum in Pregnant Females with History of Previous Caesarean Section

Background: The placenta attaching improperly to or invading the myometrium can cause placenta accreta spectrum (PAS), a potentially lethal obstetric disease.
Aim: This study aimed to test the diagnostic accuracy of 2D ultrasound in the diagnosis of placenta accreta during weeks 14–18 of pregnancy.
Subjects and methods: From May to September 2024, this prospective cohort study in which one hundred and five pregnant women with a history of previous Cesarean birth between weeks 14 and 18 and who were suspected of having placenta accreta, which is characterized by the placenta occupying the bottom part of the uterus, came to the Outpatient Clinic for standard prenatal care.
Results: For early diagnosis, diagnostic performance for transvaginal ultrasound performance to detect placenta accreta spectrum for any suspicion in early diagnosis and demonstrated an accuracy of 66.5%, with a P value < 0.05. The sensitivity was 66% and the specificity 67%. And to detect placenta accreta spectrum for high suspicion in early diagnosis and demonstrated an accuracy of 62% with a P value < 0.05. The sensitivity was 64.3% and the specificity 59.7%. For late diagnosis, diagnostic performance for transvaginal ultrasound performance to detect placenta accreta spectrum for any suspicion in late diagnosis and demonstrated an accuracy of 88.3%, with a P value < 0.001. The sensitivity was 85.6% and the specificity 91.0%. And to detect placenta accreta spectrum for high suspicion in late diagnosis and demonstrated an accuracy of 90.4% with a P value < 0.001. The sensitivity was 87.1% and the specificity 93.8%.
Conclusion: When ultrasound is used for late diagnosis (between 30 and 32 weeks) as opposed to early diagnosis (between 14 and 18 weeks), it demonstrated greater accuracy, sensitivity, and specificity for detecting placenta accreta spectrum. In both early and late diagnosis, the diagnostic performance improved as the degree of suspicion rises.