Ultrasound/Imaging
Poster Session 4
Olivia Grubman, MD,MPH
Mount Sinai West
New York, NY, United States
Mackenzie Mitchell, BA, MA
Mount Sinai
New York, NY, United States
Thomas Owens, MD
Dr Thomas Owens
Mount Sinai West
New York, NY, United States
Mia A. Heiligenstein, MD
Resident
Stony Brook University Hospital
Amityville, NY, United States
Tirtza Spiegel Strauss, MD
Fellow
Maimonides Medical Center
New York, NY, United States
Elianna Kaplowitz, MPH
Mount Sinai Hospital
New York, NY, United States
Zainab Al-Ibraheemi, MD
Mount Sinai West
N Caldwell, NJ, United States
Graham Ashmead, MD
Roosevelt Hospital
New York, NY, United States
Lois Brustman, MD
St. Luke's Roosevelt Hospital Center
New York, NY, United States
Farrah N. Hussain, MD
Assistant Professor
Mount Sinai West
New York, NY, United States
There are no universal guidelines for transvaginal ultrasound (TVUS) at time of anatomy scan. TVUS can provide information on placental location and cervical length (CL), but may lead to more interventions. As a quality assurance initiative, a universal TVUS (UTVUS) protocol at the time of anatomy scan was started at our institution. This study was conducted to assess whether there was a decrease in preterm birth (PTB), postpartum hemorrhage (PPH), and neonatal intensive care unit (NICU) admission once UTVUS was implemented.
Study Design:
This was a retrospective cohort study performed on singleton gestations from February 2021-January 2022. During the first six months of the study period, patients only had a TVUS based on risk factors (history of cervical procedure, history of prior PTB, placenta appears low lying or cervix appears short on abdominal ultrasound) (pre group). The second half of the study period, UTVUS was implemented at the time of anatomy scan (post group).
Results:
A total of 2118 patients were included. There were 1037 patients in the pre group, of which 161 underwent TVUS based on high risk factors. The post group/UTVUS included 1081 patients. Regarding patient characteristics, patients in the pre group had statistically significant earlier gestational age at first TVUS (p< 0.0001), were less likely to have had a prior PTB < 36 weeks (p=0.03), and were more likely to have a history of cervical procedure (p=0.0006) than patients in the post group. However, the proportion of patients with PTB, PPH, or NICU admission did not significantly differ between the two groups even after adjusting for cofounders (p >0.05).
Conclusion: Our data shows that UTVUS did not decrease adverse pregnancy outcomes. In addition, the implementation of UTVUS increases discomfort for the patient, duration of the scan and is an additional cost. Therefore, surveillance by abdominal ultrasound may be reasonable with addition of TVUS based on risk factors.