title: Evaluation of sonographic diagnostic criteria for placenta accreta.
abstract: OBJECTIVE
  To compare the diagnostic value of reported sonographic criteria for placenta accreta and to develop a composite score system for antenatal evaluation.
  
  
  METHODS
  Sixty-six women at risk for placenta accreta were examined for 9 cases of placenta accreta that were confirmed at delivery. The performance of previously reported gray-scale and Doppler sonographic criteria for the diagnosis of placenta accreta was analyzed individually. A composite score system was developed by combining selected sensitive or specific sonographic criteria, and its performance was evaluated.
  
  
  RESULTS
  The criteria of obliteration of retroplacental clear space, a myometrial thickness of <1 mm, presence of vessels bridging placenta and uterine margin, disruption of the placental-uterine wall interface, and vessels crossing the sites of interface disruption showed a statistically significant association with placenta accreta. The disruption of the placental-uterine wall interface and the presence of vessels crossing these sites were the only 2 individual criteria that could distinguish placenta accreta from non-accreta, which could also be achieved by our composite score system using a cutoff value of 40, with a sensitivity of 89% and specificity of 98%.
  
  
  CONCLUSIONS
  The diagnostic performance of the sonographic diagnostic criteria used in the diagnosis of placenta accreta varies, and a composite score system improves the overall accuracy.
authors: Department of Obstetrics and Gynaecology, School of Medicine and Health Sciences, University of Otago, P.O. Box 7343, Wellington, New Zealand.
authors: Hong Soo
authors: HS
authors: Wong
authors: Ying Kei
authors: YK
authors: Cheung
authors: Jane
authors: J
authors: Zuccollo
authors: John
authors: J
authors: Tait
authors: Kevin C
authors: KC
authors: Pringle
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D010921:Placenta Accreta / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D011247:Pregnancy; D012680:Sensitivity and Specificity; D014463:Ultrasonography