الفهرس 
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Abstract
Placenta accreta is defined as failure of separation of the placenta from uterine wall, it is one of the main causes of maternal mortality and morbidity. The condition is characterized by invasive placentation and catastrophic hemorrhage. Recent guidelines suggested that placenta accreta spectrum (PAS), which includes accreta, increta, and percreta
Each case of invasive placenta represents a challenge for the obstetricians. Invasive placenta is clinically characterized by massive hemorrhage that potentially leads to disseminated intravascular coagulopathy, renal failure, and death of the mother. Thus, an early and accurate prenatal diagnosis is crucial for proper management in order to minimize serious maternal and neonatal complications. This study aims to evaluate the diagnostic and potential of cell free microRNA-29 in placenta accreta.
This study was designed to assess the diagnostic accuracy of cell free miRNA-29 in placenta accreta.
Thirty Patients were recruited from pregnant women with placenta previa based on ultrasound, admitted to the department of Obstetrics and Gynecology, Ain Shams University Maternity Hospital to be included in the study.
All the study participants were subjected to all needed workup to make sure they met the inclusion criteria of the current study then they were investigated by ultrasound scan for detection of placental invasion.
Patients were divided into 2 groups:
• group I: women with placenta previa without invasion.
• group II: women with placenta previa with accrete.
According to the operative finding and histopathological finding.
Samples for miRNA-29 detection were collected form venous blood samples of pregnant women, centrifuged at 4000 rpm for 10 minutes and plasma were separated and stored at -20ºc until analyzed by Real-time quantitative RTPCR after delivery by cesarean section.
This study results revealed a high significant difference for miR-29 expression observed between placenta Previa without invasion and placenta previa with accreta (p<0.001) and examined by a Receiving Operating characteristics analysis (ROC) in order to define the optimum cut off level of miRNA-29 expression as a diagnostic marker.
In the Receiving Operating characteristics analysis (ROC), miR-29 showed a diagnostic potential to discriminate cases with placenta previa from accreta at the cut-off value ≤ 6.0, with a test sensitivity of 100% and specificity of 94 %.
When all this findings is taken together, the use of miRNA-29 expression level in maternal serum could be a useful diagnostic marker of placenta accreta.