
The retrospective multicenter cohort study aimed to evaluate prenatal ultrasound features associated with complications during surgery and assess the agreement between prenatal ultrasound assessment and histopathological confirmation of placenta accreta spectrum (PAS) in high-risk patients. Two experienced operators independently reviewed deidentified ultrasound images. PAS diagnosis was confirmed by failed placental detachment and histological examination. Of the 102 high-risk patients, 66 had evidence of PAS at birth. The interobserver agreement for the prenatal assessment of PAS was moderate (kappa statistic = 0.47), and morbidity was more common in cases with a concordant prenatal diagnosis of PAS. The high probability of PAS on prenatal assessment was strongly associated with histopathologic confirmation.
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