OC08.02: Study on the relationship between Caesarean scar pregnancy and placental accreta using ultrasound monitoring

The study aims to use ultrasound monitoring to investigate the relationship between Caesarean scar pregnancy (CSP) and placental accreta (PLA), to provide guidance for the clinical management of early CSP. We conducted a retrospective analysis of 24 patients diagnosed with CSP in our Hospital from 2015 to 2022. All patients chose to continue their pregnancy. They were divided into low-risk and high-risk groups based on the characteristics of their ultrasound images, and continuous follow-up was conducted, to evaluate the severity of placental accreta. The outcomes of the two groups were then compared. Among the 24 patients, 22 were in the low-risk(CSP1andII) group, 13 of them were assessed by the ultrasound “Placental accreta scoring system” as having a score greater than 5 (which predicts the occurrence of placental increta or percreta). 12 in the 13patients were diagnosed with placental accreta after surgery (2 were accreta, 7werel increta, 3 were percreta). The sensitivity of ultrasound diagnosis was 77%. The remaining 9 patients consistently had a score of ≤ 5 points (which predicts no placental accreta or only placental accreta). Among them, 5 cases were diagnosed with placental accreta, and 4 cases did not have placental accreta. The specificity of ultrasound diagnosis was 100%. In the low-risk group, all patients obtained live births after 28 weeks. Two patients in the high-risk(CSPIII) group, with an placenta score of ≥ 10, were predicted to have placenta percreta. Surgery confirmed that they were both placental percreta. The rates of hysterectomy in the low-risk group and high-risk group were 2/22 and 2/2, respectively, and the difference was statistically significant (<0.05). The risk of CSP developing into placental accreta is high, and the classification of CSP by ultrasound can predict pregnancy outcomes, providing clinical guidance for CSP patients who are willing to continue their pregnancy.