Placenta accreta risk - antepartum score (PAR-A) in predicting clinical outcomes of placenta accreta spectrum: A multicenter validation study.

Abstract

OBJECTIVE\nTo validate the use of PAR-A score as a predictive tool of clinical outcomes of placenta accreta spectrum (PAS) METHODS: This is a prospective study, conducted in 6 PAS specialized centers in 6 different countries. The study was conducted between October 1st , 2020, and March 31st , 2021. Women who were provisionally diagnosed with PAS during pregnancy were considered eligible. Machine-learning based PAR-A score was calculated. Diagnostic performance of PAR-A score was evaluated using receiver operating characteristic (ROC) curve, for perioperative massive blood loss and admission to intensive care unit (ClinicalTrials.gov identifier NCT04525001).\n\n\nRESULTS\nout of 97 eligible women, 86 were included. PAS-associated massive blood loss occurred in 10 patients (11.63%). Median PAR-A scores of massive blood loss in the current cohort were 8.9 (interquartile range 6.9-14.1). In predicting massive blood loss, area under curve (AUC) of PAR-A scores was 0.85 (95% confidence interval [CI] 0.74-0.95), which was not significantly different from the original cohort (p = 0.2). PAR-A score prediction of intensive care unit admission was slightly higher compared to the original cohort (0.88 [95%CI 0.81-0.95], p = 0.06).\n\n\nCONCLUSION\nPAR-A score is a novel scoring system of PAS outcomes, which showed external validity based on current data.