gynecology and obstetrics medical project, gynecology journal, obstetrics, gynecologic oncology, reproductive medicine, gynecological endoscopy, ultrasonography, gynecology articles

Ginekologia i Poloznictwo
ISSN 1896-3315 e-ISSN 1898-0759

Intracervical lakes as a sonographic marker of placenta accreta spectrum (PAS) in patients with previa and low-lying placenta: A prospective observational study


Author(s): Mohamed M. Salman*, Karam M. Bayomy, Nader M. Ibrahim and Mohamed M. Abd El Aleem

Objective: We evaluated the diagnostic accuracy of a new ultrasound sign, “intracervical lakes”, in predicting presence and outcome of placenta accreta spectrum (PAS).

Methods: An observational study was done on 110 women with placenta previa or low-lying placenta at 36 weeks’ gestation, referred to Ain Shams Maternity Hospital between January 2021and December 2021, with all examined by ultrasound to confirm placental location, presence/absence/degree of invasion, and intracervical lakes sign. All underwent caesarean section and final diagnosis of PAS was made intraoperatively. Specimen was histologically examined.

Results: US findings predicted PAS with sensitivity 76.8 % and specificity 85.2 %, while PAS sign+ intracervical lakes increased specificity to 98.1 %, positive predictive value 96.2 %, LR+ 24.11 % and DOR 42.74, but decreased other characteristics. US findings predicted percreta with sensitivity 95.2 % and NPV 98.3 %, and intracervical lakes did not markedly decrease sensitivity 90.5 % and NPV 97.6 %, but markedly increased other diagnostic characteristics with specificity 92.1%.

Conclusion: Intracervical lakes may become a marker of deep villus invasion in women with ultrasound-suspected PAS and predict the occurrence of severe maternal morbidity with specificity 98.1%.