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Abstract To investigate the value of serum alpha fetoprotein（AFP）and creatine kinase（CK）levels combined with magnetic resonance imaging (MRI) during the second and the third trimester of pregnancy for evaluating the placenta previa complicated with placenta accrete of pregnant women. Methods: A total of 80 pregnant women with placenta previa complicated with placenta accreta who had delivered by cesarean section from January 2018 to January 2021 were selected in research group retrospectively，which included 29 cases with adhesion type of placenta previa in group A，27 cases with implant type of placenta previa in group B, and 24 cases with penetration type of placenta previa in group C according to the results of MRI. In addition，60 pregnant women who required regular antenatal examination and MRI examination after cesarean section and during the same period were selected in control group. The serum AFP，CK levels and the results of MRI examination during the second and the third trimester of pregnancy of the women in the two groups were analyzed. Results: The serum AFP and CK levels of the women in group C, group B, and group A had decreased gradually, and which of the women were all significantly higher than those of the women in the control group (P<0.05). There was no significant difference in the diagnostic coincidence rate of MRI (92.6%, 85.2% vs. 83.3%) of the women among group A, group B, and group C (P>0.05). The area under the curve (AUC) of serum AFP and CK levels combined with MRI for evaluating the placenta previa complicated with placenta implantation during the second trimester of pregnancy were 0.924 (95%CI: 0.805-0.982) and 0.905 (95%CI: 0.821-0.964), respectively, the sensitivity of which were 90.2% and 88.4%, respectively, and the specificity of which were 95.3% and 91.8%, respectively. The AUC of MRI for evaluating the placenta previa complicated with placenta implantation during the third trimester of pregnancy was 0.811 (95%CI: 0.691-0.863), the sensitivity of which was 80.7%, and the specificity of which was 93.2%. The AUC of serum AFP level for evaluating the placenta previa complicated with placenta implantation during the second and the third trimester of pregnancy were 0.705 (95%CI：0.602-0.764) and 0.782 (95%CI：0.7010.835), respectively, the sensitivity of which were 70.0% and 78.4%, respectively, and the specificity of which were 69.3% and 71.3%, respectively. The AUC of serum CK level for evaluating the placenta previa complicated with placenta implantation during the second and the third trimester of pregnancy were 0.692 (95%CI：0.591-0.702) and 0.764 (95%CI：0.624-0.820), respectively, the sensitivity of which were 69.9% and 75.2%, respectively, and the specificity of which were 74.3% and 70.3%, respectively. Conclusion: The serum AFP and CK levels combined with MRI of the pregnant women during the second and the third trimester of pregnancy for evaluating the placenta previa complicated with placenta accreta has higher value in clinic.
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