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All Journal International Journal of Public Health Science (IJPHS) MEDIA MEDIKA INDONESIANA Jurnal Kedokteran Diponegoro Journal of Biomedicine and Translational Research Indonesian Journal of Obstetrics & Gynecology Science Jurnal Kesehatan Reproduksi Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia) Medica Hospitalia Diponegoro International Medical Journal (DIMJ) Indonesian Journal of Perinatology
Julian Dewantiningrum
Department Of Obstetrics And Gynecology, Faculty Of Medicine, Diponegoro University, Semarang, Indonesia
Biochemistry, Genetics & Molecular Biology Dentistry Health Professions Medicine & Pharmacology Neuroscience Nursing Public Health

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Placenta Accreta Index (PAI) Score Association With Incidence of Placenta Accreta Spectrum, E-Cadherin Expression, Maternal and Neonates Outcome Martina Wibowo; Agoes Oerip Poerwoko; Raden Soerjo Hadijono; Julian Dewantiningrum; Besari Adi Pramono; Ratnasari Dwi Cahyanti; Dik Puspasari; Hermawan Hermawan
Indonesian Journal of Obstetrics and Gynecology Volume 14. No. 2 April 2026
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v14i2.2436

Abstract

Objective: To evaluated the Placenta Accreta Index (PAI) score for its association with histopathological diagnosis, E-cadherin expression, and clinical outcomes in Placenta Accreta Spectrum (PAS) disorders.Methods: A retrospective cross-sectional analysis was conducted on 81 patients with PAS at a tertiary referral center. Data on PAI scores, histopathology, and maternal/neonatal outcomes were collected. Statistical analysis compared outcomes between patients with PAI scores ≥4 and <4.Results: A PAI score ≥4 was not significantly associated with the final histopathological diagnosis of PAS (p=1.000). E-cadherin expression was lower in PAS tissue, but not significantly correlated with PAI score. However, a PAI score ≥4 was significantly associated with increased intraoperative blood loss (1275 mL vs. 968 mL, p=0.005) and a higher likelihood of requiring blood transfusion (RR 1.56, 95% CI 1.126–2.150, p=0.007). No significant associations were found between PAI score and adverse neonatal outcomes.Conclusion: The PAI score is a practical tool for predicting surgical morbidity, specifically hemorrhage and transfusion risk, in pregnancies clinically suspected of PAS, supporting its use for preoperative planning in resource-limited settings. Its utility as a primary diagnostic marker for histopathological invasion appears limited in a high-risk referral population.Keywords: E-cadherin, maternal outcome, neonatal outcome, placenta accreta spectrum, PAI Score
Co-Authors Adhi Pribadi Afina Yuliani Putri Agoes Oerip Poerwoko Aldiansyah, Dudy Aldika Akbar, Muhammad Ilham Aloysius Suryawan Anantyo, Dimas T. Anantyo, Dimas Tri Andonotopo, Wiku Anityo Mochtar, Arufiadi Annastasia Ediati Bachnas, Muhammad Adrianes Bambang Rahardjo Besari Adi Pramono Besari Adi Pramono Cahya Novenita Azzahra Cahyanti , Ratnasari Dwi Ch Nawangsih Prihharsanti Cut Meurah Yeni Darmawan, Ernawati Dewi Astri Purnaningtyas Dik Puspasari Dwi Pudjonarko Ediwibowo Ambari Evert Solomon Pangkahila Hadijono, Raden Soerjo Hapsari, Anggiyasti Vidya Hary Tjahjanto Haryana, Bambang Herman Kristanto Hermawan Hermawan I Nyoman Hariyasa Sanjaya Inu Mulyantoro Kurjak, Asim Kurube, Isabela Marsialina Larasati, Irene Astrid Liza Afriliana Maria Mexitalia Martina Wibowo Mazaya, Radiva H. Mochtar, Arufiadi Anityo Mona Galatia Marpaung Mulyantoro, Inu Muniroh, Muflihatul Nani Maharani Noor Pramono Nugraha, Eka Djatnika Nuswil Bernolian Pramono, Mochammad Besari Adi Putra, Very Great Eka Putri Sekar Wiyati Qolby, Qonita Nur Rabiah Adawiyah Raden Soerjo Hadijono Radith Aulia Rahmad R. B. Wicaksono Rahmadi, Farid A. Rahman, Farhan Aulia Ratnasari Dwi Cahyanti Ratnasari Dwi Cahyanti, Ratnasari Dwi Rizky Syahriar Syoufana Ryan Saktika Mulyana Sarastry, Razmaeda Soejoenoes, Ariawan Soerjo Hadijono Sri Sulistyowati Stanojevic, Milan Suharyo Hadisaputro Teuku Mirza Iskandar, Teuku Mirza Thaufik Hidayat, Syarief Theresia Monica Rahardjo Umami, Hayyina Maslikhatul Ushan, Ery Perdana Wardana, Setya Girindra Widyawati Widyawati Wiradnyana, Anak Agung Gede Putra Yan Wisnu Prajoko Yuli Trisetiyono, Yuli Zaki Hetami