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Prenatal Identification Of Invasive Placentation Using Ultrasound A Systematic Review And Meta Analysis



Prenatal Identification Of Invasive Placentation Using Ultrasound A Systematic Review And Meta Analysis







The accuracy of prospective prenatal detection of invasive placentation is unclear. was to conduct a systematic review and meta-analysis to assess the performance of ultrasound (US) in at-risk women for prenatal identification of invasive placentation. Medline, EMBASE, The Cochrane Database of Systematic Reviews, Database of s of Reviews of Effects (DARE) and The Cochrane Central Register of Controlled Trials (CENTRAL) were searched using the search terms a oPlacenta accretaa , a placenta incretaa , a oplacenta percretaa , a oultrasounda , a omagnetic resonance imaging (MRI)a , a invasive placentaa , a oinfiltrative placentaa . Two authors independently abstracted data from the articles. Sensitivity, specificity, positive and negative predictive values (PPV and NPV) and their 95% confidence interval (CI) for each study were calculated. Forest plots and summary receiver operating characteristic (SROC) curves were produced. Between-study heterogeneity was explored both graphically and statistically. The MOOSE guidelines were followed. Twenty-three studies of 3707 pregnancies at risk for invasive placentation were included. The overall performance of ultrasound for the antenatal detection of invasive placentation was as follows: sensitivity of 90.30% (95% CI: 86.6-93.3), a specificity of 93.81% (95% CI: 92.4-95.0), a PLR of 8.40 (95% CI: 5.3-13.4), a NLR of 0.16 (95% CI: 0.12-0.23) and a DOR of 83.36 (95% CI: 42.6-163.0). Among the different ultrasound signs color Doppler had the best predictive accuracy (sensitivity: 90.72, 95% CI 85.2-94.7; specificity: 87.70, 95% CI 84.6-90.4; PLR: 7.77, 95% CI 3.3-18.4; NLR: 0.17, 95% CI 0.10-0.29; DOR: 69.02, 95% CI 22.8-208.9). US has a high accuracy for prenatal diagnosis of disorders of invasive placentation in high-risk women. Use of color Doppler improves the test performance.

Accession: 037514021

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