The timing of the delivery is planned carefully on a case-by-case basis at around 34 to 38 weeks to achieve optimal fetal maturity and avoid the chance of spontaneous labor. Given that the majority of PASD are associated with placenta previa, they are at increased risk of prepartum hemorrhage as gestational age increases, which in turn is associated with increased risk of unscheduled delivery [11,12]. Although a planned delivery is preferred, a contingency plan for emergent delivery should be in place [4]. Obtaining radiologic and clinical data when PASD The American College of Radiology seeks and encourages collaboration with other organizations on the development of the ACR Appropriateness Criteria through society representation on expert panels. Participation by representatives from collaborating societies on the expert panel does not necessarily imply individual or society endorsement of the final document. Reprint requests to: publications@acr.org Placenta Accreta Spectrum Disorder is first suspected can play a significant role in formulating an appropriate delivery strategy and contingency plan. Ideally after initial diagnosis, high-risk patients should be followed closely by experienced centers where emergent mobilization of a multidisciplinary team needed for a scheduled or unscheduled delivery is feasible [13]. Discussion of Procedures by Variant Variant 1: Low risk for placenta accreta spectrum disorder. No known clinical risk factors. Initial imaging. Women who do not have any clinical risk factors and no evidence of previa during an 18- to 22-week anatomy scan can be followed per ACOG clinical guidelines [4]. MRI Abdomen and Pelvis (Without and With IV Contrast) There is no relevant literature to support the use of MRI without or with intravenous (IV) contrast in the initial imaging evaluation for low-risk pregnancy unless concerning findings are present on routine ultrasound (US) [13].
Placenta Accreta Spectrum Disorder. The timing of the delivery is planned carefully on a case-by-case basis at around 34 to 38 weeks to achieve optimal fetal maturity and avoid the chance of spontaneous labor. Given that the majority of PASD are associated with placenta previa, they are at increased risk of prepartum hemorrhage as gestational age increases, which in turn is associated with increased risk of unscheduled delivery [11,12]. Although a planned delivery is preferred, a contingency plan for emergent delivery should be in place [4]. Obtaining radiologic and clinical data when PASD The American College of Radiology seeks and encourages collaboration with other organizations on the development of the ACR Appropriateness Criteria through society representation on expert panels. Participation by representatives from collaborating societies on the expert panel does not necessarily imply individual or society endorsement of the final document. Reprint requests to: publications@acr.org Placenta Accreta Spectrum Disorder is first suspected can play a significant role in formulating an appropriate delivery strategy and contingency plan. Ideally after initial diagnosis, high-risk patients should be followed closely by experienced centers where emergent mobilization of a multidisciplinary team needed for a scheduled or unscheduled delivery is feasible [13]. Discussion of Procedures by Variant Variant 1: Low risk for placenta accreta spectrum disorder. No known clinical risk factors. Initial imaging. Women who do not have any clinical risk factors and no evidence of previa during an 18- to 22-week anatomy scan can be followed per ACOG clinical guidelines [4]. MRI Abdomen and Pelvis (Without and With IV Contrast) There is no relevant literature to support the use of MRI without or with intravenous (IV) contrast in the initial imaging evaluation for low-risk pregnancy unless concerning findings are present on routine ultrasound (US) [13].