What are the novel findings of this work?Our findings show that ultrasound and magnetic resonance imaging (MRI) have similar sensitivity and specificity for the diagnosis of placenta accreta spectrum (PAS) in high-risk women. However, the meta-analysis was complicated by heterogeneous subsets of women and methodology across studies. What are the clinical implications of this work?Our systematic review included studies focusing on women who had undergone both MRI and ultrasound examinations, allowing a direct comparison of the two techniques. Given that ultrasound and MRI had similar performance in the diagnosis of PAS in high-risk women, the choice between these modalities could be based on availability of equipment and expertise of the center. However, the pooled sensitivity and specificity of both modalities were far from optimal, suggesting that further exploration of other approaches for the diagnosis of PAS is needed.

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