PDF(Pubmed)
Abstract：
OBJECTIVE: To evaluate the diagnostic accuracy of ultrasound and in the diagnosis of Placenta accreta spectrum (PAS).
METHODS: Screening of MEDLINE, CENTRAL, other bases from inception to February 2022 using the keywords related to placenta accreta, increta, percreta, morbidly adherent placenta, and preoperative ultrasound diagnosis.
METHODS: All available studies- whether were prospective or retrospective- including cohort, case control and cross sectional that involved prenatal diagnosis of PAS using 2D or 3D ultrasound with subsequent pathological confirmation postnatal were included. Fifty-four studies included 5307 women fulfilled the inclusion criteria, PAS was confirmed in 2025 of them.
METHODS: Extracted data included settings of the study, study type, sample size, participants characteristics and their inclusion and exclusion criteria, Type and site of placenta previa, Type and timing of imaging technique (2D, and 3D), severity of PAS, sensitivity and specificity of individual ultrasound criteria and overall sensitivity and specificity.
RESULTS: The overall sensitivity was 0.8703, specificity was 0.8634 with -0.2348 negative correlation between them. The estimate of Odd ratio, negative likelihood ratio and positive likelihood ratio were 34.225, 0.155 and 4.990 respectively. The overall estimates of loss of retroplacental clear zone sensitivity and specificity were 0.820 and 0.898 respectively with 0.129 negative correlation. The overall estimates of myometrial thinning, loss of retroplacental clear zone, the presence of bridging vessels, placental lacunae, bladder wall interruption, exophytic mass, and uterovesical hypervascularity sensitivities were 0.763, 0.780, 0.659, 0.785, 0.455, 0.218 and 0.513 while specificities were 0.890, 0.884, 0.928, 0.809, 0.975, 0.865 and 0.994 respectively.
CONCLUSIONS: The accuracy of ultrasound in diagnosis of PAS among women with low lying or placenta previa with previous cesarean section scars is high and recommended in all suspected cases.
BACKGROUND: Number CRD42021267501.
METHODS: Screening of MEDLINE, CENTRAL, other bases from inception to February 2022 using the keywords related to placenta accreta, increta, percreta, morbidly adherent placenta, and preoperative ultrasound diagnosis.
METHODS: All available studies- whether were prospective or retrospective- including cohort, case control and cross sectional that involved prenatal diagnosis of PAS using 2D or 3D ultrasound with subsequent pathological confirmation postnatal were included. Fifty-four studies included 5307 women fulfilled the inclusion criteria, PAS was confirmed in 2025 of them.
METHODS: Extracted data included settings of the study, study type, sample size, participants characteristics and their inclusion and exclusion criteria, Type and site of placenta previa, Type and timing of imaging technique (2D, and 3D), severity of PAS, sensitivity and specificity of individual ultrasound criteria and overall sensitivity and specificity.
RESULTS: The overall sensitivity was 0.8703, specificity was 0.8634 with -0.2348 negative correlation between them. The estimate of Odd ratio, negative likelihood ratio and positive likelihood ratio were 34.225, 0.155 and 4.990 respectively. The overall estimates of loss of retroplacental clear zone sensitivity and specificity were 0.820 and 0.898 respectively with 0.129 negative correlation. The overall estimates of myometrial thinning, loss of retroplacental clear zone, the presence of bridging vessels, placental lacunae, bladder wall interruption, exophytic mass, and uterovesical hypervascularity sensitivities were 0.763, 0.780, 0.659, 0.785, 0.455, 0.218 and 0.513 while specificities were 0.890, 0.884, 0.928, 0.809, 0.975, 0.865 and 0.994 respectively.
CONCLUSIONS: The accuracy of ultrasound in diagnosis of PAS among women with low lying or placenta previa with previous cesarean section scars is high and recommended in all suspected cases.
BACKGROUND: Number CRD42021267501.
摘要：
目的：评价超声对胎盘植入谱(PAS)的诊断准确性。
方法：筛选MEDLINE，中部,从成立到2022年2月的其他基地使用与胎盘植入相关的关键词，增量,Percreta,病态粘附胎盘，术前超声诊断。
方法：所有可用的研究-无论是前瞻性还是回顾性研究-包括队列，包括病例对照和横断面，涉及使用2D或3D超声对PAS进行产前诊断并随后在产后进行病理确认。54项研究包括5307名符合纳入标准的女性，其中PAS在2025年得到确认。
方法：提取的数据包括研究的设置，研究类型,样本量,参与者特征及其纳入和排除标准，前置胎盘类型和部位,成像技术的类型和时序(2D，和3D），PAS的严重性，个体超声标准的敏感性和特异性以及总体敏感性和特异性。
结果：总体敏感性为0.8703，特异性为0.8634，-0.2348之间呈负相关。奇数比的估计，负似然比和正似然比分别为34.225、0.155和4.990。胎盘后透明区敏感性和特异性丧失的总体估计分别为0.820和0.898，呈0.129负相关。子宫肌层变薄的总体估计，胎盘后透明区丧失，桥接血管的存在，胎盘腔隙，膀胱壁中断,外生肿块，子宫膀胱高血管敏感性分别为0.763、0.780、0.659、0.785、0.455、0.218和0.513，而特异性分别为0.890、0.884、0.928、0.809、0.975、0.865和0.994。
结论：在低洼或前置胎盘有剖宫产瘢痕的妇女中，超声诊断PAS的准确性较高，建议在所有可疑病例中使用。
背景：编号CRD42021267501。
方法：筛选MEDLINE，中部,从成立到2022年2月的其他基地使用与胎盘植入相关的关键词，增量,Percreta,病态粘附胎盘，术前超声诊断。
方法：所有可用的研究-无论是前瞻性还是回顾性研究-包括队列，包括病例对照和横断面，涉及使用2D或3D超声对PAS进行产前诊断并随后在产后进行病理确认。54项研究包括5307名符合纳入标准的女性，其中PAS在2025年得到确认。
方法：提取的数据包括研究的设置，研究类型,样本量,参与者特征及其纳入和排除标准，前置胎盘类型和部位,成像技术的类型和时序(2D，和3D），PAS的严重性，个体超声标准的敏感性和特异性以及总体敏感性和特异性。
结果：总体敏感性为0.8703，特异性为0.8634，-0.2348之间呈负相关。奇数比的估计，负似然比和正似然比分别为34.225、0.155和4.990。胎盘后透明区敏感性和特异性丧失的总体估计分别为0.820和0.898，呈0.129负相关。子宫肌层变薄的总体估计，胎盘后透明区丧失，桥接血管的存在，胎盘腔隙，膀胱壁中断,外生肿块，子宫膀胱高血管敏感性分别为0.763、0.780、0.659、0.785、0.455、0.218和0.513，而特异性分别为0.890、0.884、0.928、0.809、0.975、0.865和0.994。
结论：在低洼或前置胎盘有剖宫产瘢痕的妇女中，超声诊断PAS的准确性较高，建议在所有可疑病例中使用。
背景：编号CRD42021267501。
