Rendimiento de la ecografía en espectro de placenta accreta: revisión sistemática y meta-análisis en red

Objetivo: realizar una revisión sistemática de la literatura con meta-análisis en red para evaluar el rendimiento diagnóstico de los signos ecográficos en la detección prenatal del PAS. Métodos: se llevó a cabo una revisión sistemática de la literatura siguiendo los lineamientos PRISMA-DTA y un meta...

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Autores:: Sánchez Valencia, Liliana Carolina

Tipo de recurso:: https://purl.org/coar/resource_type/c_7a1f

Fecha de publicación:: 2025

Institución:: Universidad El Bosque

Repositorio:: Repositorio U. El Bosque

Idioma:: spa

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dc.title.none.fl_str_mv	Rendimiento de la ecografía en espectro de placenta accreta: revisión sistemática y meta-análisis en red
dc.title.translated.none.fl_str_mv	Diagnostic Performance of Ultrasound Signs for the Detection of Placenta Accreta Spectrum: A Systematic Review and Network Meta-analysis
title	Rendimiento de la ecografía en espectro de placenta accreta: revisión sistemática y meta-análisis en red
spellingShingle	Rendimiento de la ecografía en espectro de placenta accreta: revisión sistemática y meta-análisis en red Placenta accreta Ultrasonografía prenatal Diagnóstico prenatal Revisión sistemática Meta-análisis en red Placenta accreta Prenatal ultrasonography Prenatal diagnosis Systematic review Network meta-analysis WQ 200
title_short	Rendimiento de la ecografía en espectro de placenta accreta: revisión sistemática y meta-análisis en red
title_full	Rendimiento de la ecografía en espectro de placenta accreta: revisión sistemática y meta-análisis en red
title_fullStr	Rendimiento de la ecografía en espectro de placenta accreta: revisión sistemática y meta-análisis en red
title_full_unstemmed	Rendimiento de la ecografía en espectro de placenta accreta: revisión sistemática y meta-análisis en red
title_sort	Rendimiento de la ecografía en espectro de placenta accreta: revisión sistemática y meta-análisis en red
dc.creator.fl_str_mv	Sánchez Valencia, Liliana Carolina
dc.contributor.advisor.none.fl_str_mv	Romero Infante, Ximena Carolina Sarmiento Hernádez, Diana Piedad de la Hoz Valle, José Antonio
dc.contributor.author.none.fl_str_mv	Sánchez Valencia, Liliana Carolina
dc.contributor.orcid.none.fl_str_mv	0000-0003-1738-3549
dc.subject.none.fl_str_mv	Placenta accreta Ultrasonografía prenatal Diagnóstico prenatal Revisión sistemática Meta-análisis en red
topic	Placenta accreta Ultrasonografía prenatal Diagnóstico prenatal Revisión sistemática Meta-análisis en red Placenta accreta Prenatal ultrasonography Prenatal diagnosis Systematic review Network meta-analysis WQ 200
dc.subject.keywords.none.fl_str_mv	Placenta accreta Prenatal ultrasonography Prenatal diagnosis Systematic review Network meta-analysis
dc.subject.nlm.none.fl_str_mv	WQ 200
description	Objetivo: realizar una revisión sistemática de la literatura con meta-análisis en red para evaluar el rendimiento diagnóstico de los signos ecográficos en la detección prenatal del PAS. Métodos: se llevó a cabo una revisión sistemática de la literatura siguiendo los lineamientos PRISMA-DTA y un meta-análisis en red. La prueba índice fue determinada como el uso de la ecografía transabdominal y/o transvaginal y como prueba estándar de referencia se utilizó la histopatología. Resultados: el análisis de 25 estudios incluidos (n=73955), mostró una sensibilidad global de 0.86 (IC 95%: 0.76-0.92) y una especificidad de 0.85 (IC 95%: 0.76-0.91), con considerable heterogeneidad. Al excluir estudios con valores extremos o alto riesgo de sesgo, la sensibilidad global fue 0.84 y 0.91, respectivamente y la especificidad 0.84 y 0.70, observándose una reducción en la heterogeneidad. El meta-análisis en red evidenció una fuerte coexistencia entre la interfase uterovesical con pérdida de la zona clara y la interfase uterovesical con vasos puentes y vasos nutricios. Conclusiones: La ecografía obstétrica muestra un buen rendimiento diagnóstico para la detección prenatal del PAS, evidenciando una alta sensibilidad y especificidad. No obstante, la considerable heterogeneidad observada entre los estudios incluidos resalta la necesidad de estandarizar los criterios ecográficos para el diagnóstico de PAS.
publishDate	2025
dc.date.accessioned.none.fl_str_mv	2025-07-31T21:46:44Z
dc.date.available.none.fl_str_mv	2025-07-31T21:46:44Z
dc.date.issued.none.fl_str_mv	2025-07
dc.type.coar.fl_str_mv	http://purl.org/coar/resource_type/c_7a1f
dc.type.local.spa.fl_str_mv	Tesis/Trabajo de grado - Monografía - Especialización
dc.type.coar.none.fl_str_mv	https://purl.org/coar/resource_type/c_7a1f
dc.type.driver.none.fl_str_mv	info:eu-repo/semantics/bachelorThesis
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dc.identifier.uri.none.fl_str_mv	https://hdl.handle.net/20.500.12495/15617
dc.identifier.instname.spa.fl_str_mv	instname:Universidad El Bosque
dc.identifier.reponame.spa.fl_str_mv	reponame:Repositorio Institucional Universidad El Bosque
dc.identifier.repourl.none.fl_str_mv	repourl:https://repositorio.unbosque.edu.co
url	https://hdl.handle.net/20.500.12495/15617
identifier_str_mv	instname:Universidad El Bosque reponame:Repositorio Institucional Universidad El Bosque repourl:https://repositorio.unbosque.edu.co
dc.language.iso.fl_str_mv	spa
language	spa
dc.relation.references.none.fl_str_mv	1. Jauniaux E, Bhide A, Kennedy A, Woodward P, Hubinont C, Collins S, et al. FIGO consensus guidelines on placenta accreta spectrum disorders: Prenatal diagnosis and screening. International Journal of Gynecology and Obstetrics. 2018 Mar 1;140(3):274–80. 2. Morlando M, Sarno L, Napolitano R, Capone A, Tessitore G, Maruotti GM, et al. Placenta accreta: Incidence and risk factors in an area with a particularly high rate of cesarean section. Acta Obstet Gynecol Scand. 2013 Apr;92(4):457–60. 3. Carusi DA. The Placenta Accreta Spectrum: Epidemiology and Risk Factors [Internet]. 2018. Available from: www.clinicalobgyn.com 4. Farquhar CM, Li Z, Lensen S, McLintock C, Pollock W, Peek MJ, et al. Incidence, risk factors and perinatal outcomes for placenta accreta in Australia and New Zealand: A case-control study. BMJ Open. 2017 Oct 1;7(10). 5. Mehrabadi A, Hutcheon JA, Liu S, Bartholomew S, Kramer MS, Liston RM, et al. Contribution of placenta accreta to the incidence of postpartum hemorrhage and severe postpartum hemorrhage. Obstetrics and Gynecology. 2015 Apr 24;125(4):814–21. 6. Pagani G, Cali G, Acharya G, Trisch IT, Palacios-Jaraquemada J, Familiari A, et al. Diagnostic accuracy of ultrasound in detecting the severity of abnormally invasive placentation: a systematic review and meta-analysis. Vol. 97, Acta Obstetricia et Gynecologica Scandinavica. Wiley-Blackwell; 2018. p. 25–37. 7. Hobson SR, Kingdom JC, Murji A, Windrim RC, Carvalho JCA, Singh SS, et al. No. 383-Screening, Diagnosis, and Management of Placenta Accreta Spectrum Disorders. Journal of Obstetrics and Gynaecology Canada. 2019 Jul 1;41(7):1035–49. 8. Jauniaux E, Kingdom JC, Silver RM. A comparison of recent guidelines in the diagnosis and management of placenta accreta spectrum disorders. Vol. 72, Best Practice and Research: Clinical Obstetrics and Gynaecology. Bailliere Tindall Ltd; 2021. p. 102–16. 9. Shainker SA, Coleman B, Timor IE, Bhide A, Bromley B, Cahill AG, et al. Special Report of the Society for Maternal-Fetal Medicine Placenta Accreta Spectrum Ultrasound Marker Task Force: Consensus on definition of markers and approach to the ultrasound examination in pregnancies at risk for placenta accreta spectrum. Am J Obstet Gynecol. 2021 Jan 1;224(1):B2–14. 10. Fratelli N, Fichera A, Prefumo F. An update of diagnostic efficacy of ultrasound and magnetic resonance imaging in the diagnosis of clinically significant placenta accreta spectrum disorders. Vol. 34, Current Opinion in Obstetrics and Gynecology. Lippincott Williams and Wilkins; 2022. p. 287–91. 11. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med. 2009 Jul 21;6(7):e1000097. 12. McInnes MDF, Moher D, Thombs BD, McGrath TA, Bossuyt PM, Clifford T, et al. Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies The PRISMA-DTA Statement. JAMA - Journal of the American Medical Association. 2018 Jan 23;319(4):388–96. 13. Whiting PF, Rutjes AWS, Westwood ME, Mallett S, Deeks JJ, Reitsma JB, et al. QUADAS-2: A Revised Tool for the Quality Assessment of Diagnostic Accuracy Studies [Internet]. 2011. Available from: www.annals.org 14. Higgins JPT, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses Testing for heterogeneity. 15. Shim S, Yoon BH, Shin IS, Bae JM. Network meta-analysis: application and practice using Stata. Epidemiol Health. 2017;39:e2017047. 16. Chaimani A, Higgins JPT, Mavridis D, Spyridonos P, Salanti G. Graphical Tools for Network Meta-Analysis in STATA. PLoS One. 2013 Oct 3;8(10). 17. White IR. Network meta-analysis. Vol. 15, The Stata Journal. 2015. 18. Haba RM, Pristavu AI, Cobzeanu ML, Carauleanu A, Sadiye Scripcariu I, Vasilache IA, et al. Predicting Placenta Accreta Spectrum Disorders in a Cohort of Pregnant Patients in the North-East Region of Romania—Diagnostic Accuracy of Ultrasound and Magnetic Resonance Imaging. Diagnostics. 2022 Sep 1;12(9). 19. Dellapiana G, Mok T, Platt LD, Silverman NS, Han CS, Esakoff TF. Sensitivity of antenatal ultrasound in diagnosing posterior placenta accreta spectrum disorders. J Perinat Med. 2024 Mar 1;52(3):288–93. 20. Rahimi-SharbafP F, JamalP A, MesdaghiniaP E, Abedzadeh-KalahroudiP M, NiroomaneshP S, AtoofP F, et al. Ultrasound detection of placenta accreta in the first trimester of pregnancy. Vol. 12, Iran J Reprod Med. 2014. 21. Cali G, Forlani F, Foti F, Minneci G, Manzoli L, Flacco ME, et al. Diagnostic accuracy of first-trimester ultrasound in detecting abnormally invasive placenta in high-risk women with placenta previa. Ultrasound in Obstetrics and Gynecology. 2018 Aug 1;52(2):258–64. 22. Chalubinski KM, Pils S, Klein K, Seemann R, Speiser P, Langer M, et al. Prenatal sonography can predict degree of placental invasion. Ultrasound in Obstetrics and Gynecology. 2013 Nov;42(5):518–24. 23. Bartels HC, Walsh JM, Carroll S, Downey P, O’Brien DJ, McAuliffe FM, et al. Prenatal detection of placenta accreta spectrum using a sonographic checklist. Acta Obstet Gynecol Scand. 2024; 24. Califano G, Saccone G, Maria Maruotti G, Bartolini G, Quaresima P, Morelli M, et al. Prenatal identification of invasive placentation using ultrasound in women with placenta previa and prior cesarean delivery. European Journal of Obstetrics and Gynecology and Reproductive Biology. 2024 Nov 1;302:97–103. 25. Gadelrab AE, Aboelghar WMA, Swedan KH, Nasreldin EA, Elshahawy A. Accuracy of three-dimensional multislice view Doppler in diagnosis of placenta accreta spectrum. Italian Journal of Gynaecology and Obstetrics. 2022 Mar 1;34(1):11–8. 26. Maged AM, Abdelaal H, Salah E, Saad H, Meshaal H, Eldaly A, et al. Prevalence and diagnostic accuracy of Doppler ultrasound of placenta accreta in Egypt. Journal of Maternal-Fetal and Neonatal Medicine. 2018 Apr 3;31(7):933–9. 27. Khalil WEM, Mortada ;, Abdel-Rahman EA, Farag OBB, Saber SMA. ACCURACY OF MULTI-SLICE 3D-DOPPLER IN DIAGNOSIS OF MORBIDLY ADHERENT PLACENTA IN COMPARISON WITH 2D-DOPPLER. Vol. 72, AIN SHAMS MEDICAL JOURNAL. 2021. 28. Chou MM, Ho ESC, Lee YH. Prenatal diagnosis of placenta previa accreta by transabdominal color Doppler ultrasound. Ultrasound in Obstetrics and Gynecology. 2000;15(1):28–35. 29. Boroomand Fard M, Kasraeian M, Vafaei H, Jahromi MA, Arasteh P, Shahraki HR, et al. Introducing an efficient model for the prediction of placenta accreta spectrum using the MCP regression approach based on sonography indexes: How efficient is sonography in diagnosing accreta? BMC Pregnancy Childbirth. 2020 Feb 17;20(1). 30. Warshak CR, Eskander R, Hull AD, Scioscia AL, Mattrey RF, Benirschke K, et al. Accuracy of Ultrasonography and Magnetic Resonance Imaging in the Diagnosis of Placenta Accreta [Internet]. 2006. Available from: http://journals.lww.com/greenjournal 31. Movahedi M, Farahbod F, Mootamedi M. Evaluation and comparison of sensitivity and specificity of ultrasonography in placenta accreta diagnosis in the second and third trimesters. Adv Biomed Res. 2023 Jan 1;12(1):188. 32. Golshan R, Faraji A, Ahmadi Mohtasham M, Eghbali E, Ghatrehsamani F, Khalafi M, et al. The Diagnostic Accuracy of Sonography for Detecting Placenta Accreta Spectrum in Pregnant Women, With Placenta Previa. Journal of Diagnostic Medical Sonography. 2023 Sep 1;39(5):471–9. 33. Jamali AH, Sherwani A, Sheikh A, Farhat K, Tariq S, Mustafa I. Diagnostic Accuracy of Ultrasound in Morbidly Adherent Placenta Keeping Histopathology as Gold Standard. Pakistan Journal of Medical and Health Sciences. 2023 May 30;17(5):600–3. 34. 60. Ultrasound and MRI accordance and features in the prenatal diagnosis of placenta accreta. 35. Baumann HE, Pawlik LKA, Hoesli I, Schoetzau A, Schoenberger H, Butenschoen A, et al. Accuracy of ultrasound for the detection of placenta accreta spectrum in a universal screening population. International Journal of Gynecology and Obstetrics. 2023 Jun 1;161(3):920–6. 36. Guo P, Wu Y, Yuan X, Wan Z. Clinical diagnostic value and analysis of mri combined with ultrasound in prenatal pernicious placenta previa with placenta accreta. Ann Palliat Med. 2021 Jun 1;10(6):6753–9. 37. Sofiah S, C Fung LY. Placenta Accreta: Clinical Risk Factors, Accuracy of Antenatal Diagnosis and Effect on Pregnancy Outcome. 38. Cali G, Forlani F, Timor-Trisch I, Palacios-Jaraquemada J, Foti F, Minneci G, et al. Diagnostic accuracy of ultrasound in detecting the depth of invasion in women at risk of abnormally invasive placenta: A prospective longitudinal study. Acta Obstet Gynecol Scand. 2018 Oct 1;97(10):1219–27. 39. Lopes ES, Feitosa FEDL, Brazil AV, De Castro JDV, Da Costa JIF, Araujo Júnior E, et al. Assessment of Sensitivity and Specificity of Ultrasound and Magnetic Resonance Imaging in the Diagnosis of Placenta Accreta. Revista Brasileira de Ginecologia e Obstetricia. 2019 Jan 14;41(1):17–23. 40. Rezk MAA, Shawky M. Grey-scale and colour Doppler ultrasound versus magnetic resonance imaging for the prenatal diagnosis of placenta accreta. Journal of Maternal-Fetal and Neonatal Medicine. 2016 Jan 17;29(2):218–23. 41. Shih JC, Jaraquemada JMP, Su YN, Shyu MK, Lin CH, Lin SY, et al. Role of three-dimensional power Doppler in the antenatal diagnosis of placenta accreta: Comparison with gray-scale and color Doppler techniques. Ultrasound in Obstetrics and Gynecology. 2009 Feb;33(2):193–203. 42. Kamankesh R, Hanafi M, Bakhtiari Z, Masihi S. Evaluation of the sensitivity and specificity of 2D and color Doppler sonography in the detection of placenta accreta in pregnant women. J Family Med Prim Care. 2020;9(2):1009. 43. Lin MW, Hsu HC, Hui Tan EC, Shih JC, Lee CN, Yang JH, et al. Risk of placenta accreta spectrum following myomectomy: a nationwide cohort study. Am J Obstet Gynecol. 2024 Aug 1;231(2):255.e1-255.e10. 44. Deeks JJ HJAD. Analysing data and undertaking meta-analyses. version 6.3. Thomas J, Chandler J, Cumpston M, Li T, Page MJ et al., editors. 2022
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spelling	Romero Infante, Ximena CarolinaSarmiento Hernádez, Diana Piedadde la Hoz Valle, José AntonioSánchez Valencia, Liliana Carolina0000-0003-1738-35492025-07-31T21:46:44Z2025-07-31T21:46:44Z2025-07https://hdl.handle.net/20.500.12495/15617instname:Universidad El Bosquereponame:Repositorio Institucional Universidad El Bosquerepourl:https://repositorio.unbosque.edu.coObjetivo: realizar una revisión sistemática de la literatura con meta-análisis en red para evaluar el rendimiento diagnóstico de los signos ecográficos en la detección prenatal del PAS. Métodos: se llevó a cabo una revisión sistemática de la literatura siguiendo los lineamientos PRISMA-DTA y un meta-análisis en red. La prueba índice fue determinada como el uso de la ecografía transabdominal y/o transvaginal y como prueba estándar de referencia se utilizó la histopatología. Resultados: el análisis de 25 estudios incluidos (n=73955), mostró una sensibilidad global de 0.86 (IC 95%: 0.76-0.92) y una especificidad de 0.85 (IC 95%: 0.76-0.91), con considerable heterogeneidad. Al excluir estudios con valores extremos o alto riesgo de sesgo, la sensibilidad global fue 0.84 y 0.91, respectivamente y la especificidad 0.84 y 0.70, observándose una reducción en la heterogeneidad. El meta-análisis en red evidenció una fuerte coexistencia entre la interfase uterovesical con pérdida de la zona clara y la interfase uterovesical con vasos puentes y vasos nutricios. Conclusiones: La ecografía obstétrica muestra un buen rendimiento diagnóstico para la detección prenatal del PAS, evidenciando una alta sensibilidad y especificidad. No obstante, la considerable heterogeneidad observada entre los estudios incluidos resalta la necesidad de estandarizar los criterios ecográficos para el diagnóstico de PAS.Especialista en Medicina Materno-FetalEspecializaciónA systematic review of the literature and a network meta-analysis were conducted using histopathology as the reference standard to evaluate the diagnostic performance and correlation of ultrasound signs. The review followed PRISMA-DTA guidelines. The index test was defined as the use of transabdominal and/or transvaginal ultrasound, with histopathology serving as the reference standard. Analysis of the 25 included studies (n = 73,955) demonstrated an overall sensitivity of 0.86 (95% CI: 0.76–0.92) and specificity of 0.85 (95% CI: 0.76–0.91), with considerable heterogeneity. After excluding studies with extreme values or a high risk of bias, the overall sensitivity was 0.84 and 0.91, respectively, and specificity was 0.84 and 0.70, respectively, with reduced heterogeneity. The network meta-analysis revealed a strong coexistence between the loss of the clear zone at the uterovesical interface and the presence of bridging and feeder vessels. Taken together, these findings support the use of ultrasound as part of a multimodal diagnostic approach, in which clinical judgement and sonographer experience are essential for improving diagnostic accuracy, particularly in high-risk settings.application/pdfAttribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/Acceso abiertohttps://purl.org/coar/access_right/c_abf2http://purl.org/coar/access_right/c_abf2Placenta accretaUltrasonografía prenatalDiagnóstico prenatalRevisión sistemáticaMeta-análisis en redPlacenta accretaPrenatal ultrasonographyPrenatal diagnosisSystematic reviewNetwork meta-analysisWQ 200Rendimiento de la ecografía en espectro de placenta accreta: revisión sistemática y meta-análisis en redDiagnostic Performance of Ultrasound Signs for the Detection of Placenta Accreta Spectrum: A Systematic Review and Network Meta-analysisEspecialización en Medicina Materno-FetalUniversidad El BosqueFacultad de MedicinaTesis/Trabajo de grado - Monografía - Especializaciónhttps://purl.org/coar/resource_type/c_7a1fhttp://purl.org/coar/resource_type/c_7a1finfo:eu-repo/semantics/bachelorThesishttps://purl.org/coar/version/c_ab4af688f83e57aa1. Jauniaux E, Bhide A, Kennedy A, Woodward P, Hubinont C, Collins S, et al. FIGO consensus guidelines on placenta accreta spectrum disorders: Prenatal diagnosis and screening. International Journal of Gynecology and Obstetrics. 2018 Mar 1;140(3):274–80.2. Morlando M, Sarno L, Napolitano R, Capone A, Tessitore G, Maruotti GM, et al. Placenta accreta: Incidence and risk factors in an area with a particularly high rate of cesarean section. Acta Obstet Gynecol Scand. 2013 Apr;92(4):457–60.3. Carusi DA. The Placenta Accreta Spectrum: Epidemiology and Risk Factors [Internet]. 2018. Available from: www.clinicalobgyn.com4. Farquhar CM, Li Z, Lensen S, McLintock C, Pollock W, Peek MJ, et al. Incidence, risk factors and perinatal outcomes for placenta accreta in Australia and New Zealand: A case-control study. BMJ Open. 2017 Oct 1;7(10).5. Mehrabadi A, Hutcheon JA, Liu S, Bartholomew S, Kramer MS, Liston RM, et al. Contribution of placenta accreta to the incidence of postpartum hemorrhage and severe postpartum hemorrhage. Obstetrics and Gynecology. 2015 Apr 24;125(4):814–21.6. Pagani G, Cali G, Acharya G, Trisch IT, Palacios-Jaraquemada J, Familiari A, et al. Diagnostic accuracy of ultrasound in detecting the severity of abnormally invasive placentation: a systematic review and meta-analysis. Vol. 97, Acta Obstetricia et Gynecologica Scandinavica. Wiley-Blackwell; 2018. p. 25–37.7. Hobson SR, Kingdom JC, Murji A, Windrim RC, Carvalho JCA, Singh SS, et al. No. 383-Screening, Diagnosis, and Management of Placenta Accreta Spectrum Disorders. Journal of Obstetrics and Gynaecology Canada. 2019 Jul 1;41(7):1035–49.8. Jauniaux E, Kingdom JC, Silver RM. A comparison of recent guidelines in the diagnosis and management of placenta accreta spectrum disorders. Vol. 72, Best Practice and Research: Clinical Obstetrics and Gynaecology. Bailliere Tindall Ltd; 2021. p. 102–16.9. Shainker SA, Coleman B, Timor IE, Bhide A, Bromley B, Cahill AG, et al. Special Report of the Society for Maternal-Fetal Medicine Placenta Accreta Spectrum Ultrasound Marker Task Force: Consensus on definition of markers and approach to the ultrasound examination in pregnancies at risk for placenta accreta spectrum. Am J Obstet Gynecol. 2021 Jan 1;224(1):B2–14.10. Fratelli N, Fichera A, Prefumo F. An update of diagnostic efficacy of ultrasound and magnetic resonance imaging in the diagnosis of clinically significant placenta accreta spectrum disorders. Vol. 34, Current Opinion in Obstetrics and Gynecology. Lippincott Williams and Wilkins; 2022. p. 287–91.11. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med. 2009 Jul 21;6(7):e1000097.12. McInnes MDF, Moher D, Thombs BD, McGrath TA, Bossuyt PM, Clifford T, et al. 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