{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T10:34:11Z","timestamp":1787654051699,"version":"build-2736575974"},"reference-count":21,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,4,1]],"date-time":"2022-04-01T00:00:00Z","timestamp":1648771200000},"content-version":"vor","delay-in-days":0,"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":[[2022,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Improvement in the antenatal diagnosis of placenta accreta spectrum (PAS) would allow preparation for delivery in a referral center, leading to decreased maternal morbidity and mortality. Our objectives were to assess the performance of classic ultrasound signs and to determine the value of novel ultrasound signs in the detection of PAS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective cohort study of women with second\u2010trimester placenta previa who underwent third\u2010trimester transvaginal ultrasound and all women with PAS in seven medical centers. A retrospective image review for signs of PAS was conducted by three maternal\u2013fetal medicine physicians. Classic signs of PAS were defined as placental lacunae, bladder\u2010wall interruption, myometrial thinning and subplacental hypervascularity. Novel signs were defined as small placental lacunae, irregular placenta\u2013myometrium interface (PMI), vascular PMI, non\u2010tapered placental edge and placental bulge towards the bladder. PAS was diagnosed based on difficulty in removing the placenta or pathological examination of the placenta. Multivariate regression analysis was performed and receiver\u2010operating\u2010characteristics (ROC) curves were generated to assess the performance of combined novel signs, combined classic signs and a model combining classic and novel signs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 385 cases with placenta previa were included, of which 55 had PAS (28 had placenta accreta, 11 had placenta increta and 16 had placenta percreta). The areas under the ROC curves for classic markers, novel markers and a model combining classic and novel markers for the detection of PAS were 0.81 (95%\u2009CI, 0.75\u20130.88), 0.84 (95%\u2009CI, 0.77\u20130.90) and 0.88 (95%\u2009CI, 0.82\u20130.94), respectively. A model combining classic and novel signs performed better than did the classic or novel markers individually (<jats:italic>P<\/jats:italic>\u2009=\u20090.03). An increasing number of signs was associated with a greater likelihood of PAS. With the presence of 0, 1, 2 and \u2265\u20093 classic ultrasound signs, PAS was present in 5%, 24%, 57% and 94% of cases, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We have confirmed the value of classic ultrasound signs of PAS. The use of novel ultrasound signs in combination with classic signs improved the detection of PAS. These findings have clinical implications for the detection of PAS and may help guide the obstetric management of patients diagnosed with these placental disorders. \u00a9 2021 International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.24804","type":"journal-article","created":{"date-parts":[[2021,11,2]],"date-time":"2021-11-02T08:40:38Z","timestamp":1635842438000},"page":"465-473","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Evaluation of classic and novel ultrasound signs of placenta accreta spectrum"],"prefix":"10.1002","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1504-0024","authenticated-orcid":false,"given":"D. W.","family":"Skupski","sequence":"first","affiliation":[{"name":"Department of Obstetrics &amp; Gynecology, Division of Maternal Fetal Medicine New York Presbyterian Queens  Flushing NY USA"},{"name":"The Institute for Placental Medicine New York Presbyterian Queens  Flushing NY USA"},{"name":"Weill Cornell Medicine  New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7060-8308","authenticated-orcid":false,"given":"C. M.","family":"Duzyj","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology, and Reproductive Sciences Rutgers Robert Wood Johnson Medical School  New Brunswick NJ USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Scholl","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynecology, Division of Maternal Fetal Medicine New York Presbyterian Queens  Flushing NY USA"},{"name":"The Institute for Placental Medicine New York Presbyterian Queens  Flushing NY USA"},{"name":"Weill Cornell Medicine  New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Perez\u2010Delboy","sequence":"additional","affiliation":[{"name":"Columbia University School of Medicine, Department of Obstetrics and Gynecology Division of Maternal Fetal Medicine  New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Ruhstaller","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynecology, Division of Maternal Fetal Medicine Christiana Care Health System  Wilmington DE USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. A.","family":"Plante","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine Drexel University School of Medicine  Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. A.","family":"Hart","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Lewis Katz School of Medicine at Temple University  Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. T. S.","family":"Palomares","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Maternal\u2010Fetal Medicine Saint Peter's University Hospital  New Brunswick NJ USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Ajemian","sequence":"additional","affiliation":[{"name":"Columbia University School of Medicine, Department of Obstetrics and Gynecology Division of Maternal Fetal Medicine  New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Rosen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology, and Reproductive Sciences Rutgers Robert Wood Johnson Medical School  New Brunswick NJ USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. L.","family":"Kinzler","sequence":"additional","affiliation":[{"name":"Departments of Obstetrics and Gynecology and Graduate Medical Education NYU Langone Hospital \u2013 Long Island and NYU Long Island School of Medicine  Mineola NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Ananth","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Biostatistics, Department of Obstetrics, Gynecology and Reproductive Sciences Rutgers Robert Wood Johnson Medical School  New Brunswick NJ USA"},{"name":"Department of Biostatistics and Epidemiology Rutgers School of Public Health  Piscataway NJ USA"},{"name":"Cardiovascular Institute of New Jersey (CVI\u2010NJ) Rutgers Robert Wood Johnson Medical School  New Brunswick NJ USA"},{"name":"Environmental and Occupational Health Sciences Institute (EOHSI) Rutgers Robert Wood Johnson Medical School  New Brunswick NJ USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the Perinatal Research Consortium","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,4]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.7863\/jum.1992.11.7.333"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0705.1992.02040293.x"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.20246"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.22183"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.23100"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.13238"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.21939"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.12413"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mri.2006.10.007"},{"key":"e_1_2_7_11_1","first-page":"e283","article-title":"Sonographically abnormal placenta: an association with an increased risk poor pregnancy outcomes","volume":"168","author":"Wan Masliza WD","year":"2017","journal-title":"Clin Ter"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000001005"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14952"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.13389"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2018.09.042"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.13194"},{"issue":"177","key":"e_1_2_7_17_1","first-page":"e1","article-title":"Accuracy of ultrasound for the prediction of placenta accreta","volume":"211","author":"Bowman ZS","year":"2014","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2020.09.001"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2003.11.024"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.12385"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.8827"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.21866"}],"container-title":["Ultrasound in Obstetrics &amp; Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.24804","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/uog.24804","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.24804","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,24]],"date-time":"2023-08-24T10:36:16Z","timestamp":1692873376000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.24804"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4]]},"references-count":21,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2022,4]]}},"alternative-id":["10.1002\/uog.24804"],"URL":"https:\/\/doi.org\/10.1002\/uog.24804","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4]]},"assertion":[{"value":"2021-08-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-10-13","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-04-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}