Ultrasound/Imaging
Poster Session 3
Oxana M. Zarudskaya, MD, PhD (she/her/hers)
MFM Fellow
University of Texas Health Science Center at San Antonio
San Antonio, TX, United States
Shriya Devkumar Das, BS
MS
The University of Texas Health Science Center at San Antonio
San Antonio, TX, United States
Nina Kumar, BA
MS
The University of Texas Health Science Center at San Antonio
San Antonio, TX, United States
Michael D. Berkus, MD
Associate Professor
The University of Texas Health Science Center at San Antonio
San Antonio, TX, United States
John J. Byrne, MD,MPH
Physician
The University of Texas Health Science Center at San Antonio
San Antonio, TX, United States
Angela R. Boyd, MD,PhD
Assistant Professor, OB/GYN
The University of Texas Health Science Center at San Antonio
San Antonio, TX, United States
Theresa Stewart, MD
Associate Professor, Director for Prenatal Diagnosis and Genetics
The University of Texas Health Science Center at San Antonio
San Antonio, TX, United States
Christina Hill, MD
Associate Professor, Clinic Director for Hill Country Clinic
The University of Texas Health Science Center at San Antonio
San Antonio, TX, United States
Nora M. Doyle, MD, MPH, MSc (she/her/hers)
Director Maternal Fetal Medicine Fellowship Program
The University of Texas Health Science Center at San Antonio
San Antonio, TX, United States
Patrick S. Ramsey, MD, MSPH (he/him/his)
Professor, OB/GYN
The University of Texas Health Science Center at San Antonio
San Antonio, TX, United States
Prenatal diagnosis of placenta accreta spectrum disorders (PASD) has become essential to allow for a well-conducted multidisciplinary management plan before the onset of labor to reduce maternal and fetal morbidity and mortality. In addition to risk-factor assessment, first-line modalities for predicting PASD are two-dimensional grayscale ultrasound (US) and color Doppler. Inconsistency and variability of reported US descriptors complicate multidisciplinary collaboration and research communication within and between institutions nationally and internationally.
Study Design:
We conducted a retrospective review of patients evaluated and delivered for PASD at the University Health System in San Antonio, Texas. In January 2023 our institution implemented a standardized reporting protocol for prenatal ultrasound descriptors of PASD. We compared the rate of reported standardized ultrasound descriptors and PASD type from January to July 2022 and the same period in 2023, before and after the implementation of this tool.
Results:
Of the 30 cases included, 17 (56.7%) pre-implementation and 13 (43.3) post-implementation. Pre-implementation, PASD was histologically confirmed as percreta in 69.2%, increta in 15.4%, and accreta in 15.4%. Post-implementation, PASD histological confirmation revealed of placenta percreta in all cases (100%). The type of placenta accreta based on prenatal ultrasound was reported only in 35% of cases in the pre-implementation period compared to post-implementation 85% (p=0.007). The rate of reported standardized ultrasound descriptors before and after implementation of our protocol is demonstrated in Table 1.
Conclusion:
Implementation of standardized protocol into routine practice of prenatal maternal-fetal ultrasound for PASD improves reporting rate of ultrasound descriptors, and a priori risk and placenta accreta index (PAI) score, both of which facilitate multidisciplinary collaboration and surgical planning for patients with PASD.