Role of Placenta Accreta Index for Diagnosis of Placenta Acc
Antenatal diagnosis of placenta accreta spectrum (PAS) can ensure multidisciplinary management at the center of excellence which can reduce maternal and fetal complications. This can be established by a scoring system that provides a standardized criterion for diagnosis and management. The objective of our study was to assess the placenta accreta index (PAI) and its individual parameters for the diagnosis of PAS in high-risk patients.

A prospective study was conducted on 71 pregnant women with placenta previa and previous cesarean section. All ultrasound parameters of the placenta accreta index were statistically significant for predicting the placenta accreta spectrum. ROC curve with an AUC of 0.87 95% CI of 0.77–0.94 showed that a score of 4.75 was the best cutoff value to diagnose the placenta accreta spectrum. Out of the 30 patients found to have a placental invasion, 22 had a placenta accreta index score of more than 4.75. The score was found to have a sensitivity of 73.3%, specificity 95.1%, positive predictive value 91.7%, negative predictive value 83%, and diagnostic accuracy of 85.9%.

Women with placenta previa and a history of previous CS should undergo screening by placenta accreta index, and a cutoff value of equal or more than 4.75 should be viewed with a high index of suspicion for the presence of placenta accreta spectrum.