{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T15:14:03Z","timestamp":1791472443384,"version":"4.3.4"},"reference-count":49,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2016,10,5]],"date-time":"2016-10-05T00:00:00Z","timestamp":1475625600000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2016,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the accuracy of an ultrasound\u2010based scoring system for diagnosing morbidly adherent placenta (<jats:styled-content style=\"fixed-case\">MAP<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This  study included pregnant women referred to our ultrasound unit during 2013\u20132015 because of suspected <jats:styled-content style=\"fixed-case\">MAP<\/jats:styled-content> on a previous ultrasound examination or because they had at least one previous Cesarean delivery. All women were assessed using a scoring system based on the following: number and size of placental lacunae; obliteration of the demarcation between the uterus and placenta; placental location; color Doppler signals within placental lacunae; hypervascularity of the placenta\u2013bladder and\/or uteroplacental interface zone; and number of previous Cesarean deliveries. Each criterion was assigned 0, 1 or 2 points and the sum of points yielded the final score. Patients were classified into low, moderate or high probability for <jats:styled-content style=\"fixed-case\">MAP<\/jats:styled-content> based on the final score. The presence of <jats:styled-content style=\"fixed-case\">MAP<\/jats:styled-content> was determined by the surgeon at delivery and clinical descriptions were documented in the electronic patient file. Pathological diagnoses were available only in cases that underwent hysterectomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 258 pregnant women were included in the study, of whom 23 (8.9%) were diagnosed with <jats:styled-content style=\"fixed-case\">MAP<\/jats:styled-content>. There was a statistically significant difference in the prevalence of <jats:styled-content style=\"fixed-case\">MAP<\/jats:styled-content> when women were grouped according to the scoring system, with 0.9%, 29.4% and 84.2% in the low, moderate and high probability groups, respectively (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001). All sonographic criteria of the scoring system were significantly associated with <jats:styled-content style=\"fixed-case\">MAP<\/jats:styled-content> (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001). Receiver\u2013operating characteristics (<jats:styled-content style=\"fixed-case\">ROC<\/jats:styled-content>) curves for prediction of <jats:styled-content style=\"fixed-case\">MAP<\/jats:styled-content> using the number of placental lacunae and obliteration of the uteroplacental demarcation  yielded an area under the <jats:styled-content style=\"fixed-case\">ROC<\/jats:styled-content> curve of 0.94 (95%\u2009<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 0.86\u20131.00).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our proposed scoring system is highly predictive of <jats:styled-content style=\"fixed-case\">MAP<\/jats:styled-content> in patients at risk. This allows an adequate multidisciplinary team approach for the planning and timing of delivery in such cases. Copyright \u00a9 2015 ISUOG. 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