role of placenta accreta index in predicting conservative surgery for placenta accreta spectrum

Background objective: because of varying degrees of trophoblastic tissue invasion across the uterine wall, the placenta becomes inseparable from the uterus in cases of morbidly adherent placenta, a kind of placental attachment condition. finding out how the placenta accreta index score predicts conservative surgery for placenta accreta spectrum.materials methods: from june 2022 to august 2024, 62 pregnant women over 28 weeks’ gestation were the subjects of this diagnostic accuracy study at ain shams university maternity hospital, a tertiary care facility. the women were diagnosed with placenta previa using 2d ultrasound and doppler on a placental bed with inclusion and exclusion criteria.results: placenta accreta index (pai) had significant moderate diagnostic performance and characteristics in predicting hysterectomy; was good at excluding hysterectomy but low in confirming it. placenta accreta index (pai) had significant moderate diagnostic performance and characteristics in predicting conservative surgery; it was good at confirming conservative surgery but low in excluding it. placenta accreta index (pai) had significant positive correlations with age, parity, operation duration, and hospital stay duration.conclusion: the study effectively illustrates how the placenta accreta index (pai) may be used to predict hysterectomy and conservative surgery in individuals with placenta accreta spectrum (pas). the findings indicate that the pai is a reliable diagnostic tool, with a cut-off value of 6.5 offering strong predictive power for hysterectomy, showing 80% sensitivity and 81% specificity. additionally, the pai correlates significantly with clinical factors such as age, parity, operation duration, and hospital stay, enhancing its practical value for surgical decision-making.