4.1 Review

An update of diagnostic efficacy of ultrasound and magnetic resonance imaging in the diagnosis of clinically significant placenta accreta spectrum disorders

Journal

CURRENT OPINION IN OBSTETRICS & GYNECOLOGY
Volume 34, Issue 5, Pages 287-291

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/GCO.0000000000000811

Keywords

accreta; MRI; prenatal diagnosis; screening; ultrasound

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Ultrasound and MRI are both effective tools for diagnosing PAS in high-risk populations. Ultrasound can guide management decisions and resource allocation in patients with clinically significant PAS, while routine contingent screening based on placental location and previous uterine surgery is effective in identifying PAS disorders in public healthcare settings.
Purpose of review Systematic screening and diagnosis of placenta accreta spectrum disorder (PAS) either by ultrasound or magnetic resonance imaging (MRI) would allow referral of high-risk women to specialized multidisciplinary teams. We aimed to report recent findings regarding the diagnostic accuracy of ultrasound and magnetic resonance imaging in the diagnosis of PAS. Recent findings Recent evidence from the literature shows that both ultrasound and MRI are good tests to identify PAS in high-risk populations. Ultrasound can also be used safely to guide management decisions, concentrating greater resources in patients with the higher risk of clinically significant PAS requiring complex peripartum management. Moreover, there are increasing data showing that routine contingent screening for PAS disorders based on the finding of a placenta implanted low in the uterine cavity and previous uterine surgery is effective in a public healthcare setting. A contingent screening strategy for PAS is feasible if placental location is routinely assessed during routine scans, and may even start from the first trimester of pregnancy. Ultrasound is an effective tool to screen pregnancies at high risk of PAS. In such pregnancies, ultrasound and MRI are effective imaging modalities for guiding management.

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