Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia)
Volume 14. No. 2 April 2026

Placenta Accreta Index (PAI) Score Association With Incidence of Placenta Accreta Spectrum, E-Cadherin Expression, Maternal and Neonates Outcome

Martina Wibowo (Faculty of Medicine Universitas Diponegoro Dr. Kariadi General Hospital Semarang)
Agoes Oerip Poerwoko (Faculty of Medicine Universitas Diponegoro Dr. Kariadi General Hospital Semarang)
Raden Soerjo Hadijono (Faculty of Medicine Universitas Diponegoro Dr. Kariadi General Hospital Semaran)
Julian Dewantiningrum (Faculty of Medicine Universitas Diponegoro Dr. Kariadi General Hospital Semarang)
Besari Adi Pramono (Faculty of Medicine Universitas Diponegoro Dr. Kariadi General Hospital Semarang)
Ratnasari Dwi Cahyanti (Faculty of Medicine Universitas Diponegoro Dr. Kariadi General Hospital Semarang)
Dik Puspasari (Faculty of Medicine Universitas Diponegoro)
Hermawan Hermawan (Faculty of Medicine Universitas Diponegoro Dr. Kariadi General Hospital Semarang)



Article Info

Publish Date
22 Apr 2026

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

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Journal Info

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journal

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Health Professions Medicine & Pharmacology Public Health

Description

The Indonesian Journal of Obstetrics and Gynecology is an official publication of the Indonesian Society of Obstetrics and Gynekology. INAJOG is published ...