Scoring System for the prediction of the Severity of Placenta Accrete Spectrum (PAS) in Women with Placenta Previa (PAS scoring system)

Background: Antenatal diagnosis of PAS and a multidisciplinary team approach are necessary to reduce maternal and fetal intrapartum complications. Objectives: To establish a scoring system for the prediction of the severity of placenta accrete spectrum (PAS) in women with placenta previa.Methods: This is prospective observational study was conducted on 35 pregnant females with sonographic confirmation of placenta previa, All patients were subjected to complete detailed personal and medical history, complete gynecologic and obstetric history, general examination including vital signs systems review including examination of different systems, laboratory investigations including preoperative routine investigations (CBC, liver function tests, kidney function tests, coagulation profile, virology, detailed ultrasound examination for placental lacunae, bladder uterus interface vascularity, bladder line, uterine muscle thickness, loss of demarcation between uterus and placenta and cervical length as parameters of PAS scoring system. Results: The mean age of study group was 31.14±5.80 years with mean body weight was 85.57 ±7.96 Kg, 11 females experienced antenatal vaginal bleeding. The mean PAS score in females without PAS , Accreta, Increta, Percreta was 4.00 1±.4, 8.60 ±1.72,12.50 ±1.29, 13.50 ±0.71 which was significantly higher in females with PAS p value < 0.001. The scoring system of PAS has (AUC =0.986, SE= 0.015) with p value<0.001 with cutoff point 5.5, sensitivity of 100%, specificity of 86%.Conclusion: Scoring System for severity prediction of PAS is simple and feasible modality to ascertain the presence of PAS in women with placenta previa.