Evaluating the Effectiveness of Various Prenatal Screening Methods and Diagnostic Tools for Early Detection of Placenta Accreta and Their Impact on Maternal and Fetal Outcomes

Kausar Inayat¹, Sadaf Saifullah², Talat Nelofer³, Humaira Jadoon⁴, Nargis Danish⁵, Nazish Ali⁶

¹Women Medical College, Abbottabad

²Women And Children Hospital Abbottabad

³Women Medical and Dental College Abbottabad

⁴Gynae and Obs. ayub Medical College, Abbottabad

⁵Gynae and Obs Woman Medical College Abbottabad

⁶Baqai Medical University Hospital Karachi

Abstract

Objective: The efficacy of prenatal screening methods and diagnostic modalities in the early diagnosis of placenta accreta and their effects on maternal and neonatal outcomes were evaluated. The sensitivity, specificity, advantages and drawbacks of various methods which reported in the literature for example ultrasound, MRI and Doppler ultrasound histopathological examination and biomarkers are reviewed. The aim is to provide an overview of the existing evidence-based paradigm within which it can help guide both clinical practice and areas of future research efforts.

Methods: A systematic review of literature was performed to find data on the diagnostic power and clinical value of ultrasound, MRI, Doppler ultrasonography, histopathology assessment, and biomarkers in the identification of placenta accreta. We selected studies on the basis of their relevance to prenatal screening, diagnostic accuracy parameters and maternal morbidity and mortality or neonatal outcomes.

Findings: We found that due to its accessibility and ability to assess in real-time, Ultrasound in transvaginal modality complemented with Doppler is a beneficial first line screening test given the high sensitivity and specificity. MRI gave complementary information, and added

extra anatomical details which may demonstrate an advantage in more difficult cases or suspected deep invasion. Histopathological findings after delivery confirmed the antenatal diagnosis made in all 10 cases. Biomarkers: promise in research, but limitations on the bedside

Keywords: Placenta Accreta, Prenatal Screening, Ultrasound, MRI, Doppler Ultrasound, Histopathology, Biomarkers, Maternal Outcomes, Fetal Outcomes, Diagnostic Accuracy.