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CME Credit Offered
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Abstract Award
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Poster Session 4

(1149) Intra-operative clinical 2019 FIGO classification has high correlation with histologic PASD in a high-risk population.

Friday, January 31, 2025
4:00 PM – 6:00 PM  

    Submitting Author and Presenting Author(s)

  • Oxana M. Zarudskaya, MD, PhD, RDMS (she/her/hers)

    Maternal-Fetal Medicine Fellow
    University of Texas Health Science Center at San Antonio
    San Antonio, TX, United States

    • Coauthor(s)

  • CM

    Caitlin E. Martin, MD

    Clinical Assistant Professor, Dept OB/GYN
    University of Texas Health Science Center at San Antonio
    San Antonio, Texas, United States

  • GM

    Georgia A. McCann, MD

    Associate Professor, Chief of Gynecology Oncology
    University of Texas Health Science Center at San Antonio
    San Antonio, Texas, United States

  • KI

    Kayla E. Ireland, MD, MSCI

    Associate Professor/Clinical
    University of Texas Health Science Center at San Antonio
    San Antonio, Texas, United States

  • Alixandria F. Pfeiffer, DO

    Maternal-Fetal Medicine Fellow
    University of Texas Health Science Center at San Antonio
    San Antonio, Texas, United States

  • PR

    Patrick S. Ramsey, MD, MSPH

    H. Frank Connally, Jr Professor in Obstetrics & Gynecology Chief, Division of MFM
    University of Texas Health Science Center San Antonio
    San Antonio, Texas, United States

Objective: Accurate confirmation of intra-operative diagnosis of placenta accreta spectrum disorder (PASD) is essential for proper use of resources, use or withhold uterine artery embolization, transfusion strategy, anesthesia care and post operative management.  To date there is limited data to suggest how clinical findings correlate to microscopic or histologic diagnosis, when universal clinical FIGO staging is used intra-operatively.

Study Design: We conducted a retrospective review of all patients evaluated and delivered in our center with suspected PASD between January 2022 and July 2024. At our institution we implemented a universal reporting protocol for macroscopic PASD findings during cases with suspected PASD.

Results: During the study interval, 56 cases of PASD were delivered at our center. Of these cases, 50 had FIGO staging documentation of macroscopic PASD findings intra-operatively and were included in analysis. Clinical staging was done by the operative members of our PASD team.  Histologic findings were uniformly documented by a designated pathologist.   Coefficients of correlation were assessed between the clinical grade and the histologic grade. There was a very strong coefficient of correlation between clinical and histologic FIGO grading in cases with suspected PASD – 0.96. This correlation was even stronger when analyzed grouped cased with accreta/increta/percreta 3A versus PASD cases with severe invasion (percreta 3B and 3C) – 0.99.

Conclusion: Our data demonstrated a very strong correlation between clinical and histologic/microscopic FIGO grading when used in cases with suspected PASD.