Early hematological indices as a predictor of placenta accreta in women with high suspicion of accreta

Abstract

There is a lack of early biomarkers to predict the placenta accreta spectrum; thus, searching for available and easily obtained markers such as hematological indices is an attractive option. The current study is a diagnostic accuracy study included 198 women; all women underwent an assessment of their hematological indices during their first trimester as part of their routine antenatal care. All women included in the study had a high suspicion of developing placenta accreta spectrum; the women were followed up until their delivery. White blood cell, neutrophil count, and red cell distribution width (RDW) were significantly higher in the women with accreta than those without accreta. RDW had fair ability (area under the curve, 0.707) as a predictor of accreta. RDW had the highest positive and lowest negative likelihood ratios (indicating better value than the rest of the markers). In multivariate analysis, RDW and the platelet-lymphocyte ratio were independently associated with accreta after adjustment to the effects of age, gestational age, gravida, parity, abortion, and past medical/surgical history. In conclusion, simple, early blood count parameters may be utilized for placenta accreta; RDW appears to be the best predictor of placenta accreta.