{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T15:18:31Z","timestamp":1791559111749,"version":"4.3.4"},"reference-count":22,"publisher":"Wiley","issue":"S1","license":[{"start":{"date-parts":[[2024,8,20]],"date-time":"2024-08-20T00:00:00Z","timestamp":1724112000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100016366","name":"V\u0161eobecn\u00e1 Fakultn\u00ed Nemocnice v Praze","doi-asserted-by":"publisher","award":["MH CZ \u2010 DRO\u2010VFN64165."],"award-info":[{"award-number":["MH CZ \u2010 DRO\u2010VFN64165."]}],"id":[{"id":"10.13039\/501100016366","id-type":"DOI","asserted-by":"publisher"}]}],"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>This study aimed to validate the Sargent risk stratification algorithm for the prediction of placenta accreta spectrum (PAS) severity using data collected from multiple centers and using the multicenter data to improve the model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and Methods<\/jats:title><jats:p>We conducted a multicenter analysis using data collected for the IS\u2010PAS database. The Sargent model's effectiveness in distinguishing between abnormally adherent placenta (FIGO grade 1) and abnormally invasive placenta (FIGO grades 2 and 3) was evaluated. A new model was developed using multicenter data from the IS\u2010PAS database.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The database included 315 cases of suspected PAS, of which 226 had fully documented standardized ultrasound signs. The final diagnosis was normal placentation in 5, abnormally adherent placenta\/FIGO grade 1 in 43, and abnormally invasive placenta\/FIGO grades 2 and 3 in 178. The external validation of the Sargent model revealed moderate predictive accuracy in a multicenter setting (<jats:italic>C<\/jats:italic>\u2010index 0.68), compared to its higher accuracy in a single\u2010center context (<jats:italic>C<\/jats:italic>\u2010index 0.90). The newly developed model achieved a <jats:italic>C<\/jats:italic>\u2010index of 0.74.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The study underscores the difficulty in developing universally applicable PAS prediction models. While models like that of Sargent et\u00a0al. show promise, their reproducibility varies across settings, likely due to the interpretation of the ultrasound signs. The findings support the need for updating the current ultrasound descriptors and for the development of any new predictive models to use data collected by different operators in multiple clinical settings.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.14941","type":"journal-article","created":{"date-parts":[[2024,8,21]],"date-time":"2024-08-21T22:30:38Z","timestamp":1724279438000},"page":"20-28","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["External validation of and improvement upon a model for the prediction of placenta accreta spectrum severity using prospectively collected multicenter ultrasound data"],"prefix":"10.1111","volume":"104","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7822-2434","authenticated-orcid":false,"given":"Magdalena","family":"Kolak","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Perinatology, Medical College Jagiellonian University  Krakow Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4654-7311","authenticated-orcid":false,"given":"Stephen","family":"Gerry","sequence":"additional","affiliation":[{"name":"Centre for Statistics in Medicine University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6661-6893","authenticated-orcid":false,"given":"Hubert","family":"Huras","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Perinatology, Medical College Jagiellonian University  Krakow Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5345-4688","authenticated-orcid":false,"given":"Ammar","family":"Al Naimi","sequence":"additional","affiliation":[{"name":"Division of Obstetrics &amp; Maternal Fetal Medicine, Department of Obstetrics and Gynecology University Hospital Frankfurt Goethe\u2010University  Frankfurt 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