Efficacy Of 3D Ultrasound In Detecting Morbidly Adherent Placenta

Background: Placenta Accreta Spectrum (PAS) is a life-threatening obstetric condition characterized by abnormal adherence or invasion of the placenta into the uterine wall. Early and accurate prenatal diagnosis is crucial to reduce maternal and neonatal morbidity and mortality. This study aimed to evaluate the diagnostic efficacy of three-dimensional (3D) ultrasound 3DUS in detecting PAS and its subtypes in pregnant women at ≥28 weeks of gestation.Methods: A cross-sectional study was conducted at Kasr Al-Ainy Obstetrics and Gynecology Hospital, Cairo University, involving 35 pregnant women with a gestational age of 28 weeks or more who were clinically suspected to have morbidly adherent placenta. Inclusion criteria encompassed cases with placenta previa and suspected PAS between 28–40 weeks of gestation. Results: Among the 35 participants, 21 (60%) had confirmed PAS intraoperatively (12 accreta, 7 increta, 2 percreta). 3D US showed a sensitivity of 100%, specificity of 92.9%, PPV of 95.5%, and NPV of 100% for diagnosing overall PAS, with an accuracy of 97.1%. For subtype detection, the highest diagnostic performance was observed in detecting percreta (sensitivity, specificity, PPV, and NPV all 100%), followed by increta (accuracy 97.1%) and accreta (accuracy 94%). Conclusion: 3D US demonstrates high diagnostic accuracy in detecting PAS and differentiating its subtypes, offering a reliable, non-invasive modality for preoperative assessment. Its routine application in high-risk pregnancies can guide surgical planning, reduce emergency interventions, and improve maternal and neonatal outcomes.