{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T15:18:21Z","timestamp":1791559101727,"version":"4.3.4"},"reference-count":45,"publisher":"Wiley","issue":"S1","license":[{"start":{"date-parts":[[2024,5,31]],"date-time":"2024-05-31T00:00:00Z","timestamp":1717113600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Accurate discrimination between placenta accreta spectrum (PAS) and scar dehiscence with underlying non\u2010adherent placenta is challenging both on prenatal ultrasound and intraoperatively. This can lead to overdiagnosis of PAS and unnecessarily aggressive management of scar dehiscence which increases the risk of morbidity. Several scoring systems have been published which combine clinical and ultrasound information to help diagnose PAS in women at high risk. This research aims to provide insights into the reliability and utility of existing accreta scoring systems in differentiating these two closely related but different conditions to contribute to improved clinical decision making and patient outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and Methods<\/jats:title><jats:p>A literature search was performed in four electronic databases. The references of relevant articles were also assessed. The articles were then evaluated according to the predefined inclusion criteria. Primary data for testing each scoring system were obtained retrospectively from two hospitals with specialized PAS services. Each scoring system was used to evaluate the predicted outcome of each case.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The literature review yielded 15 articles. Of these, eight did not have a clearly described diagnostic criteria for accreta, hence were excluded. Of the remaining seven studies, one was excluded due to unorthodox diagnostic criteria and two were excluded as they differed from the other systems hindering comparison. Four scoring systems were therefore tested with the primary data. All the scoring systems demonstrated higher scores for high\u2010grade PAS compared to scar dehiscence (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) with an excellent Area Under the receiver operator characteristic Curve ranging from 0.82 (95% CI 0.71\u20130.92) to 0.87 (95% CI 0.79\u20130.96) in differentiating between these two conditions. However, no statistically significant differences were noted between the low\u2010grade PAS and scar dehiscence on all scoring systems.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Most published scoring systems have no clearly defined diagnostic criteria. Scoring systems can differentiate between scar dehiscence with underlying non\u2010adherent placenta from high\u2010grade PAS with excellent diagnostic accuracy, but not for low\u2010grade PAS. Hence, relying solely on these scoring systems may lead to errors in estimating the risk or extent of the condition which hinders preoperative planning.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.14886","type":"journal-article","created":{"date-parts":[[2024,5,31]],"date-time":"2024-05-31T15:09:06Z","timestamp":1717168146000},"page":"45-55","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Differentiating placenta accreta spectrum from scar dehiscence with underlying, non\u2010adherent placenta: A systematic review of scoring systems and primary data analysis"],"prefix":"10.1111","volume":"104","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2365-6769","authenticated-orcid":false,"given":"Theophilus K.","family":"Adu\u2010Bredu","sequence":"first","affiliation":[{"name":"Nuffield Department of Women's and Reproductive Health University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6674-7682","authenticated-orcid":false,"given":"Rozi Aditya","family":"Aryananda","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology Department, Maternal Fetal Medicine, Dr Soetomo Academic General Hospital Universitas Airlangga  Surabaya Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Arkorful","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging University of Cape Coast  Cape Coast Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sam","family":"Matthewlynn","sequence":"additional","affiliation":[{"name":"Nuffield Department of Women's and Reproductive Health University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sally L.","family":"Collins","sequence":"additional","affiliation":[{"name":"Nuffield Department of Women's and Reproductive Health University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,5,31]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.23732"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.17286"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajogmf.2024.101321"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajogmf.2022.100802"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2023.03.026"},{"key":"e_1_2_11_7_1","first-page":"114","article-title":"Invasion anomaly or neovascularization? 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