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CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
Recording available 2/16-5/2
Recording available 2/16-5/2
AIUM Credit
AIUM Credit
Foundation Awardee
Foundation Awardee
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Abstract Award
Abstract Award
Foundation Awardee
Foundation Awardee

Poster Session 3

Category: Clinical Obstetrics

Poster Session 3

(966) Real-World Multi-center Validation of an Ultrasound Scoring System for Placenta Accreta Spectrum Disorders

Thursday, February 12, 2026
10:30 AM - 12:00 PM  
Foundation Awardee
Objective:
Placenta accreta spectrum disorders (PAS), a leading cause of severe obstetric morbidity, require early and accurate diagnosis. While ultrasound remains the first-line diagnostic tool, existing studies primarily focus on individual sonographic markers, with limited real-world validation of integrated scoring systems combining clinical and imaging predictors. This study aims to evaluate the diagnostic performance and clinical generalizability of a clinically integrated ultrasound scoring system for PAS, developed in 2016 and widely implemented across Chinese maternity centers.

Study Design:
A multi-center retrospective cohort study analyzed 1,499 high-risk pregnancies (prior cesarean delivery, placenta previa or uterine curettage) from 14 tertiary hospitals. The scoring system, incorporating eight ultrasound markers (e.g., placental lacunae, bladder-uterine interface interruption) and clinical risk factors, was applied to antenatal ultrasound records. Diagnostic accuracy was assessed against surgical-pathological confirmation.

Results:
The scoring system demonstrated robust diagnostic performance, with an area under the curve (AUC) of 0.785 (95% CI 0.762-0.807, P < 0.001) and 0.828 (95% CI 0.804-0.851, P < 0.001) for PAS and invasive PAS, respectively in all population. In patients with cesarean section history and placenta previa, the AUCs were the highest among the subgroups, with 0.783 (95% CI 0.735-0.831, P < 0.001) and 0.789 (95% CI 0.750-0.828, P < 0.001) for PAS and invasive PAS. The best threshold was determined to be 6.5. Nevertheless, in women without CS history and without placenta previa, the AUCs were the lowest, with 0.626 (95% CI 0.526-0.726, P < 0.001) and 0.537 (95% CI 0.395-0.678, P = 0.279) for PAS and invasive PAS.

Conclusion:
 This large-scale real-world validation confirms that the integrated ultrasound scoring system achieves high diagnostic accuracy for PAS across diverse clinical settings. A decade of systematic implementation highlights its practicality as a scalable tool for risk stratification and surgical planning in resource-varied environments.