Comparative Effectiveness of Ultrasound and MRI in Diagnosing and Managing Placenta Accreta Spectrum Disorders

Background: PAS disorders which include placenta accreta/Placenta accreta spectrum involves the abnormal anchoring of the placenta in the uterine wall. It is very important in order to prevent hazardous effects on both the mother and fetus since it is directly correlated with path of the pregnancy and further delivery. Ultrasound has usually been the main imaging technique used in PAS, but MRI has been recognized as an adjunct technique, which provides better anatomic information. The purpose of this work will be to provide a comparison of the diagnostic efficacy and role of ultrasound and MRI as a means of managing PAS. Objective: This work therefore aims and assesses the diagnostic accuracy, and clinical management implication of ultrasound in PAS disorders relative to MRI. Methods: This is a case study presented on patients with PAS who underwent both, ultrasound and MRI 3 years in a tertiary care hospital. Cohen’s kappa coefficients of agreement between the two modalities of diagnostic metrics were also computed. The study also evaluated the effect of each imaging modality for preoperative planning and outcome of the surgeries. Results: Harrington et al (2004) noted that MRI has better diagnostic sensitivity of 93% than ultrasound at 85% while its specificity stands at 95 % as compared to the 92% of ultrasound. MRI also showed the higher importance in making changes in preoperative planning (90% vs. 75%) and surgical results (95% vs. 80%). MRI was found to be superior to other imaging in the diagnosis of different forms of PAS especially placenta accreta. Conclusion: MRI is found to give better diagnostic sensitivity and better influence on management and surgical intervention of PAS than ultrasound. MRI is thus a complementary diagnostic tool to complete the evaluation of the fetus in addition to the traditional screening through ultrasound and real-time imaging. Therefore, it could be used as a guide that combining both the approaches may be the best strategy in handling PAS.