DIAGNOSIS AND MANAGEMENT CHALLENGES OF PLACENTA ACCRETA SPECTRUM DISORDERS

DIAGNOSIS AND MANAGEMENT CHALLENGES OF PLACENTA ACCRETA SPECTRUM DISORDERS (Abstract): Placenta accreta spectrum (PAS) disorders are associated with significant maternal and neonatal morbidity and mortality. The primary aim of this study was to determine the diagnostic accuracy of individual and combined ultrasound markers for predicting PAS disorders and to report the intraoperative complication rates for this category of patients. The secondary aim of this study was to reflect the clinical challenges of a case diagnosed with placenta accreta. Materials and methods: We conducted a retrospective analysis of clinical and ultrasound data from 52 pregnant patients with or without confirmed PAS disorders who gave birth in a tertiary center. Univariate analysis was used to compare differences in baseline characteristics between groups. We calculated the diagnostic accuracy of ultrasound signs for PAS disorders and the complication rates in these patients. Results: Placental lacunar spaces had a sensitivity of 83.87%, a specificity of 76.19%, and an accuracy of 80.77% for predicting PAS disorder. The best predictive performance for predicting PAS disorders was achieved when using at least three ultrasound markers, with a sensitivity of 90.32%, a specificity of 85.71%, and an accuracy of 88.46%. Urinary tract injuries were the most frequently encountered complications in patients with confirmed PAS. Conclusions: Better antenatal diagnosis of this pathology will reduce the surgical risk and improve the overall outcome for both mother and fetus. Keywords: PLA