Innovations in the Diagnosis of Placenta Accreta Spectrum: Integrating Imaging and Biomarkers for Precision Prenatal Care
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Abstract
Background: Placenta accreta spectrum (PAS) is a life-threatening obstetric complication, and increasing prevalence of this condition underscores the importance of correct and prompt diagnosis to maximize maternal and fetal outcomes. Aim and Objective: This research aims to give a response to the following question: "What is the diagnostic accuracy of ultrasound, MRI, and new biomarkers for prenatal diagnosis of placenta accreta spectrum, and how do these modalities best integrate to maximize clinical decision-making?" Methods: Systematic review and meta-analysis were conducted through searching PubMed, Scopus, Embase, and Web of Science for research articles from January 2020 to April 2025 under the terms of PAS, ultrasound, MRI, and biomarkers. Inclusion criteria were original studies comparing the diagnostic accuracy of the modalities for PAS with histopathological or intraoperative gold standard. Data extraction and quality assessment were performed independently by two reviewers. Results: Twenty studies were incorporated. Ultrasound had pooled sensitivity of 0.87 and pooled specificity of 0.86, and MRI was also as accurate. Radiomics, multiparametric MRI, and biomarker panels (miRNA, serum proteins) also enhanced diagnostic performance with AUCs of up to 0.98. Employing greater than a single diagnostic criterion and modality enhanced accuracy, particularly in complicated cases. Conclusion: Ultrasound, MRI, and new biomarkers together are highly sensitive and specific for PAS. Standardization of diagnostic criteria, validation of biomarkers, and artificial intelligence-based clinical decision support should be the agenda of future studies.
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Copyright (c) 2025 Vijayakumar Chinnasamy, Sanul Shahi K Salim, Nadha Rahim, Noula Rahim, Jamila Hameed
This work is licensed under a Creative Commons Attribution 4.0 International License.
Creative Commons License All articles published in Annals of Medicine and Medical Sciences are licensed under a Creative Commons Attribution 4.0 International License.
Vijayakumar Chinnasamy, Department of Radiology, Karuna Medical College, Vilayodi, Chittur, Palakkad, Kerala, 678103, India.
Department of Radiology, Karuna Medical College, Vilayodi, Chittur, Palakkad, Kerala, 678103, India.
Sanul Shahi K Salim, Department of Radiology, Karuna Medical College, Vilayodi, Chittur, Palakkad, Kerala, 678103, India.
Department of Radiology, Karuna Medical College, Vilayodi, Chittur, Palakkad, Kerala, 678103, India.
Nadha Rahim, Department of Radiology, Karuna Medical College, Vilayodi, Chittur, Palakkad, Kerala, 678103, India.
Department of Radiology, Karuna Medical College, Vilayodi, Chittur, Palakkad, Kerala, 678103, India.
Noula Rahim, Department of Biochemistry, Karuna Medical College, Vilayodi, Chittur, Palakkad, Kerala, 678103, India.
Department of Biochemistry, Karuna Medical College, Vilayodi, Chittur, Palakkad, Kerala, 678103, India.
Jamila Hameed, Research Mentor, Karuna Medical College, Vilayodi, Chittur, Palakkad, Kerala, 678103, India.
Research Mentor, Karuna Medical College, Vilayodi, Chittur, Palakkad, Kerala, 678103, India.
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