Abstract
Objective
To evaluate the predictive role of fetal percentile
for placental invasion anomalies in placenta previa cases. Study Design:
Retrospective studyPlace & Duration of the Study: Training and Research
Hospital, January 2018 and December 2023
Methodology
A total of 298 placenta previa cases was divided
into two groups: PAS (placenta accreta spectrum)-positive placenta previa
(n=98) and PAS-negative placenta previa (n=200). Then PAS-positive placenta
previa cases were divided into two subgroups: placenta increta-accreta
(n=59) and placenta percreta (n=39). Sociodemographic findings, obstetric
features, fetal percentile measurements between 22 and 28 gestational weeks
and perioperative characteristics of patients were recorded and compared
between groups.
Results
Fetal percentile was significantly lower in
PAS-positive placenta previa cases as compared to PAS-negative placenta
previa cases (p<0.001). Moreover, fetal percentile≤52.5 discriminated
PAS-positive placenta previa cases from PAS-negative placenta previa cases
with 75.51% sensitivity and 51.5% specificity (p<0.001, AUC=0.654). In
multivariate analysis, a fetal percentile of 52.5 and below increased the
risk of PAS by approximately 4 times (Hosmer–Lemeshow p=0.101, model
p<0.001). No significant difference was detected between placenta
percreta and placenta accreta-increta groups in terms of fetal percentile
(p=0.224).
Conclusion
Fetal percentiles calculated between 22 and 28
gestational weeks could discriminate PAS-positive placenta previa cases from
PAS-negative placenta previa cases, although it had no role in
discriminating placenta percreta from accreta and increta cases. Therefore,
the evaluation of fetal percentile in placenta previa cases can be
considered as a supportive finding in the prediction of invasion anomaly
although it does not determine the depth of invasion.
Keywords
accreta - fetal percentile - increta - percreta - placental invasion
