Table 5.1GRADE summary of findings for diagnostic accuracy of tests for placenta accreta, increta and percreta

Number of studiesNumber of womenMeasure of diagnostic accuracyQuality
SensitivitySpecificityPositive predictive valueNegative predictive valuePositive likelihood ratioNegative likelihood ratio
Grey scale transabdominal ultrasound (mean age of gestation at diagnosis = 30 ± 2.2 weeks)
1 study

(Shih et al., 2009)
7295

(79 to 100)a
76

(52 to 92)a
82

(47 to 89)a
93

(85 to 100)a
4.02

(2.18 to 7.41)a
0.06

(0.01 to 0.26)a
Low
Grey scale transvaginal ultrasound (age of gestation at diagnosis = 15 to 20 weeks)
1 study

(Comstock et al., 2009)
3386

(0.67 to 1.04)a
NC63

(0.41 to 0.84)a
NCNCNCLow
Grey scale transvaginal ultrasound (age of gestation at diagnosis = 15 to 40 weeks)
1 study

(Comstock et al., 2009)
33100

(100 to 100)a
NC48

(0.41 to 0.84)a
NCNCNCLow
Grey scale or colour Doppler ultrasound (mean age of gestation at diagnosis = 25 weeks, range 11 to 37 weeks)
1 study

(Warshak et al., 2006)
45377

(60 to 88)
96

(93 to 97)
65

(49 to 78)
98

(95 to 98)
0.20

(0.11 to 0.33)
0.24

(0.13 to 0.42)
Low
US colour Doppler (for mean age of gestation see table footnote)b
1 study

(Masselli et al., 2008)
5091

(68 to 94)
100

(85 to 100)
100

(87 to 100)
97

(75 to 100)
infinity0.08

(0.01 to 0.54)a
Moderate
1 study

(Twickler et al., 2000)
20100

(100 to 100)a
72

(46 to 99)a
75

(50 to 99)a
100

(100 to 100)a
3.60

(1.39 to 9.26)a
0Low
1 study

(Shih et al., 2009)
7292

(83 to 100)
68

(53 to 83)
76

(63 to 88)
88

(77 to 100)
2.93

(1.78 to 4.82)a
0.11

(0.03 to 0.34)a
Low
MRI (for mean age of gestation see table footnote)c
1 study

(Masselli et al., 2008)
50100

(86 to 100)
100

(90 to 100)
100

(88 to 100)
100

(89 to 100)
infinity0Moderate
1 study

(Warshak et al., 2006)
4088

(80 to 100)
100

(76 to 100)
100

(85 to 100)
82

(64 to 100)
infinitya0.11

(0.03 to 0.33)
Low
3D power colour sonography (mean age of gestation at diagnosis 30 ± 2.2 weeks)
1 study

(Shih et al., 2009)
72100

(100 to 100)
85

(73 to 97)
88

(78 to 97)
100

(100 to 100)
6.80

(3.02 to 15.27)a
0Low
a

NCC calculation

b

Masselli et al., 2008: mean age of gestation at diagnosis = 30 weeks, range 20 to 37 weeks; Twickler. et al., 2000: age of gestation at diagnosis not reported; Shih et al., 2009: mean age of gestation at diagnosis 30 ± 2.2 weeks

c

Masselli et al., 2008: mean age of gestation at diagnosis = 30 weeks, range 20 to 37 weeks; Warshak et al., 2006: mean age of gestation at diagnosis = 28 weeks, range 18 to 37 weeks)

NC not calculable

NCC calculation

Masselli et al., 2008: mean age of gestation at diagnosis = 30 weeks, range 20 to 37 weeks; Twickler. et al., 2000: age of gestation at diagnosis not reported; Shih et al., 2009: mean age of gestation at diagnosis 30 ± 2.2 weeks

Masselli et al., 2008: mean age of gestation at diagnosis = 30 weeks, range 20 to 37 weeks; Warshak et al., 2006: mean age of gestation at diagnosis = 28 weeks, range 18 to 37 weeks)

From: 5, Planned caesarean section

Cover of Caesarean Section
Caesarean Section.
NICE Clinical Guidelines, No. 132.
National Collaborating Centre for Women's and Children's Health (UK).
London: RCOG Press; 2011 Nov.
Copyright © 2011, National Collaborating Centre for Women's and Children's Health.

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