Introduction: Placenta accreta (PA) is a major life-threating obstetrical burden associated with high 
morbidity and mortality. This study aims to evaluate the role of measuring myometrial thickness in 
prediction of placenta accreta in cases with placenta previa centeralis. Aim of the work: Evaluate the 
role of measuring myometrial thickness in prediction of placenta accreta in cases with placenta previa 
centeralis. Methods: This is a prospective study carried out at Minia Maternity University Hospital, 
Egypt during the period from October 2017 to March 2019. This study included a total of 80 pregnant 
women who are admitted to the hospital for CS between 28:38 weeks of gestation. They were 
classified into 2 groups (40 women per each), group (I) Diffuse PA: include women with diffuse 
placenta accreta and group (II) Control group: include women with normally implanted placenta. 
Results: Both groups were comparable regarding age, residence and parity however, diffuse PA 
group had significantly higher number of cases with ≥ 4 previous CSs and positive history of placenta 
previa. Group (I) had lower postoperative heamoglobin and platelet count (p<0.01). myometrial 
thickness was significantly lower in PA group compared to control (0.66 ± 0.22 vs. 1.33 ± 0.38 mm, 
p<0.01). Also, group (I) had higher amount of blood transfused units and longer duration of hospital 
stay compared to control group (all p<0.01). Incidence of complications was obviously higher in PA 
group (31 cases, 82%, p<0.01). The results of the predictive value of myometrial thickness for 
placenta accrete revealed that the area under curve (AUC) was 0.958 and the best cutoff was < 0.84 
mm with a sensitivity of 92%, specificity = 82% PPV = 83%, NPV = 87.2% and accuracy of 85% 
(p<0.01). Conclusion: In conclusion, the results indicate a significant association between decreased 
myometrial thickness and placenta accreta. Also, myometrial thickness has a high predictive value for
placenta accreta in cases with complete placenta previa centeralis.