Structured reporting improves outcomes for patients with placenta accreta spectrum
Structured reporting templates can give providers more clarity on certain MRI findings, and in some cases, improve patient outcomes.
New data published in Current Problems in Diagnostic Radiology details how structured MRI reports improved the care and recovery of women with placenta accreta spectrum (PAS), ultimately being linked to a reduction of major bleeds and admissions to the intensive care unit.
PAS occurs when the placenta does not correctly adhere to the uterine myometrium. Women who have previously had cesarean sections, required uterine instrumentation, assisted reproductive techniques and who are at an advanced maternal age are considered at greater risk of developing PAS, which can significantly increase their risk of serious bleeding during childbirth.
The condition is typically diagnosed during the second and third trimester via ultrasound, and further examined on MRI exams. Although MRI provides greater detail into the placenta and its surrounding anatomy, PAS reports can vary across readers, making managing the condition challenging for what is typically numerous providers involved in patients’ care. Structured reporting for PAS could help address this, authors of the study suggest.
“Adoption of structured reporting for placental MRI may improve report clarity and help physicians systematically review the images to identify findings that may guide patient management,” corresponding author Erin Gomez, MD, with the Russell H. Morgan Department of Radiology and Radiologic Science at Johns Hopkins University School of Medicine, and colleagues explain. “Furthermore, evaluation of the clinical impact of the final diagnosis made on preoperative MRI in comparison to intraoperative and pathologic findings may help multidisciplinary care teams understand their importance.”
To determine how structured reporting affected the care of patients with PAS, the team analyzed data from the charts of women with a history of C-section and a diagnosis of PAS on postoperative pathology reports between 2008 and 2022. Of the charts examined, 13.6% were interpreted using structured reporting.
Variances between the diagnoses in preoperative imaging reports, operative findings and final pathology reports were associated with increased blood loss, the need for transfusion, being admitted to the ICU and postpartum length of stay. However, cases when structured reports were utilized were found to have significantly less discordance and less instances of ICU admission.
“While structured reporting cannot solely account for improved patient outcomes, the results of this study may be used to infer the impact that a standardized approach to image interpretation and the relationship that preoperative imaging and surgical planning may have on the quality of care for patients with PAS,” the group writes, adding that structured reports could improve coordination among the entire care team.
To learn more about the research, read the study abstract here.
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She joined Innovate Healthcare in 2021 and has since put her unique expertise to use in her editorial role with Health Imaging.