Background: Placenta accreta is a placenta where the placental villi adhere directly to the myometrium, placenta increta is a placenta where placental villi invade into the myometrium, and a placenta percreta is a placenta where the placental villi invade through the myometrium and into the serosa. About 75% of morbidly adherent placentas are placenta accretas, 18% are placenta incretas, and 7% are placenta percretas.
Objective: To detect the changes of serum amyloid A in women with morbidly adherent placenta, to assess the changes of serum amyloid A in women with morbidly adherent placenta and to assess use serum amyloid A as biological marker beside ultrasound & doppler findings for prenatal detection of morbidly adherent placenta.
Patients and Methods: This study was conducted on women attending Al Azhar  University Maternity Hospital, Obstetric clinic or emergency room and admitted to antepartum inpatient high-risk service. The current study had been conducted on 60 pregnant women who were divided into three equal groups as follows: Group I: placenta previa. Group II: placenta accreta or increta and Group III (control group): included normal pregnant women.
Results: Regarding sensitivity and specificity of serum amyloid-A, maternal serum amyloid-A level ≥15.3 (μg/mL) had high specificity& PPV, and moderate sensitivity& NPV in differentiating previa group. Also, level ≥15.3 (μg/mL) had high specificity& PPV and low sensitivity& NPV in differentiating accreta group from control group. In addition to that maternal serum amyloid-A level ≥15.3 (μg/mL) had high specificity& PPV and low sensitivity& NPV in differentiating previa/accreta groups.
Conclusion: Morbidly adherent placenta (MAP) was characterized by failure of the placenta to separate at delivery, with potential for significant perinatal and maternal morbidity and mortality. Detection of level of maternal SAA can be used as an additional tool to detect MAP.