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Federación Mexicana de Ginecología y Obstetricia, A.C.

2024, Number 11

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Ginecol Obstet Mex 2024; 92 (11)

Diagnostic accuracy and ultrasoundpathological agreement of the accreta spectrum in patients with anomalous placental insertion

García EM, Lara SB, Caldiño SF

Language: Spanish
References: 33
Page: 450-463
PDF size: 417.11 Kb.


ABSTRACT

Objective: To determine the diagnostic accuracy and concordance of ultrasound findings with groups 1, 2 and 3 of the placenta accreta spectrum proposed by FIGO, according to the anatomopathologic study.
Materials and Methods: Observational, descriptive, cross-sectional, retrospective, comparative, single-center, uncontrolled study carried out at the Hospital de Ginecoobstetricia 4 Luis Castelazo Ayala between 2013 and 2021. To predict the spectrum of placenta accreta, the area under the ROC curve was used to evaluate the overall ultrasound performance. Risk factors were analyzed by logistic regression to identify significant associations with the diagnosis of placenta accreta spectrum.
Results: We included 151 patients with a diagnosis of anomalous placental abruption and a presumptive diagnosis of placenta accreta spectrum out of a total of 176 records reviewed. The overall prevalence of placental abruption was 20.9% (95%CI: 14.9-26.8). The prevalence during the study period was 51 cases per 11,000 births (0.46%) and 58 cases per 12,000 births (0.48%). The cumulative incidence of the placenta accreta spectrum in patients with anomalous placental insertion was 0.21 (95%CI: 0.15-0.27).
Conclusions: The overall diagnostic accuracy was more than 80%, with an increase to more than 90% with increasing placental infiltration. The kappa index for positive results was 84%, indicating excellent concordance between ultrasound and histopathologic findings in confirmed cases of placenta accreta spectrum. For negative results, concordance was also high, with a specificity of 93%, effectively excluding cases without placenta accreta spectrum.


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