Objective: To determine the accuracy of magnetic resonance imaging (MRI) in detection of abnormal placentation.

Methods: We included 60 patients with suspicion of abnormal placentation of age 25 to 40 years presenting in 2^nd or 3^rd trimester with risk factors of abnormal placentation such as previous C-section, placenta previa and advanced age having signs of abnormal placentation on ultrasonography. The patients were recruited from Jan-2019 to Sep-2020 from the department of radiology, Lahore General Hospital, Lahore.  All patients underwent MRI evaluation to determine placental abnormalities. All patients were followed till their delivery to confirm the diagnosis of abnormal placentation.

Results: Mean age was 31.24±3.75 years. Mean gestational age was 33.5±5.25 weeks. On MRI, placenta accreta was diagnosed in 23 (38.3%) cases, containing 15 (25%) cases of placenta accreta, 6 (10%) cases placenta percereta and 2 (3.33%) cases of placenta increta. The sensitivity of MRI was 84.0%, specificity was 94.3%, PPV was 91.2% and NPV 89.2%.

Conclusion: MRI is a superior imaging modality for the early evaluation of abnormal placentation in high risk suspected patients. It has an acceptable accuracy taking intra-operative or histopathology findings as gold standard.