What is the Best Predictor for Diagnosis of Placenta Accreta?: An Evidence-Based Review

The incidence of placenta accreta and maternal death are substantially increased due to the increased rate cesarean section [1,2]. The incidence of placenta accreta reported approximately 0.8 to 3 per 1000 deliveries. Maternal mortality related to placenta accreta and its complications occurs approximately as high as 6-7% [3]. Placenta accreta is the most common cause for emergency postpartum hysterectomy and may lead to severe maternal morbidity and mortality [4,5]. It is possibly lead to massive hemorrhage, transfusion, and prolonged length of stay [6]. Antenatal diagnosis of placenta accreta is important because it could reduce the morbidities, i.e. blood loss and need for blood transfusion [7,8]. The gold standard diagnosis of placenta accreta will be determined by histology evaluation [9]. Several attempts i.e. ultrasound index measurement, plasma cell-free placental mRNA assay [10], MRI examination [10], clinical risk factors analysis and multi-parameter predictor had been studied to develop better diagnostic accuracy for prediction of placenta accreta. Color-doppler ultrasound remains the first line modality for diagnosis of placenta accreta, however it has a wide-range of predictive values. We aim to appraise several studies finding at the accuracy value of the predictors of placenta accreta.