Mahalingam et al reported a scoring system for the diagnosis of placenta accreta. The authors are from Sri Ramachandra Medical College and Research Institute in Chennai, India.
Patient selection: pregnant woman, usually third trimester
Evaluation: pelvic MRI
Parameters:
(1) previous history of Cesarean delivery or uterine surgery
(2) gravida count
(3) placenta praevia
(4) loss of the uterine-placenta interface
(5) focal thinning of myometrium
(6) heterogeneous placenta with intra-placental vascular channels
(7) dark bands on T2-weighted images
(8) focal uterine bulge (outer surface)
Parameters
Findings
Points
previous history
no
0
yes
1
gravida
0 or 1
0
>= 2
1
placenta praevia
no
0
yes
1
loss of U-P interface
no
0
yes
1
focal myometrial wall
< 2 mm
1
>= 2 mm
0
heterogeneous placenta
no
0
yes
1
dark bands on T2 images
no
0
yes
1
focal uterine bulge
no
0
yes
1
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 8
• The higher the score the greater the chances of placenta accreta.
Score
Probability Placenta Accreta
0 to 3
low
4 or 5
moderate
6 to 8
high
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