Ultrasound Scoring System for Diagnosis and Prediction of Severity and Surgical Outcomes of Placenta Accreta Spectrum

Primary Objective:

• To determine the optimal cutoff values of the ultrasound score for different PAS subtypes (no PAS, placenta accreta, placenta increta, and placenta percreta).
• To evaluate the diagnostic accuracy of the novel Ultrasound Scoring
• System in predicting the severity of Placenta Accreta Spectrum (PAS) (placenta accreta, increta, and percreta).

Secondary Objective:

• To correlate the novel ultrasound score with intraoperative findings (considered the gold standard) during cesarean delivery, including the degree of placental invasion and the need for surgical interventions (hysterectomy, bladder repair).
• To assess the relationship between the novel ultrasound score and postoperative complications, such as:

• Requirement for hysterectomy
• Bladder or bowel injury
• Blood transfusion requirement
• ICU admission rates
• To explore the potential for integrating the Ultrasound Scoring System with other clinical indicators (e.g., patient age, parity, and history of cesarean sections) to enhance the predictive accuracy for PAS.

Inclusion criteria

• Pregnant women aged 18 to 45 years.
• Gestational age ≥28 weeks at the time of enrollment.
• Diagnosed Placenta Previa with a history of:

• One or more previous cesarean sections
• Uterine scarring due to previous surgery as (myomectomy, D&C, Metroplasty).
• Singleton pregnancy.

Exclusion criteria

• Women with multiple pregnancies (twins, triplets, etc.).
• Pregnancies complicated by acute medical conditions (e.g., heart failure, uncontrolled diabetes).
• Prior history of Blood diseases. (other than those related to pregnancy).
• Women who refuse to participate or withdraw consent during the study.