Seminars in perinatology
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Morbidly adherent placenta, which describes placenta accreta, increta, and percreta, implies an abnormal implantation of the placenta into the uterine wall. The incidence of placenta accreta has increased significantly over the past several decades, with the main risk factors include prior cesarean section and placental previa. ⋯ The optimum time for planned delivery for a patient with placenta accreta is around 34-35 weeks following a course of corticosteroid injection. The successful management of placenta accreta includes a multidisciplinary care team approach with the successful management relying heavily on the prenatal diagnosis of this entity and preparing for the surgical management in a multidisciplinary approach by assuring the most skilled team is available for those patients.
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Seminars in perinatology · Oct 2013
ReviewObstetric ultrasound utilization in the United States: data from various health plans.
There is currently a lack of published data on ultrasound utilization in obstetrics in the United States. In order to get some meaningful information on this topic, we analyzed de-identified data obtained from large insurance providers and underwriters that covered large segment of the United States population in various geographic areas of the country. ⋯ Another important aspect of the data is a higher than expected utilization of the targeted 76811 ultrasound examination, with utilization rates between 30% and 50%, beyond the original intention of the targeted code. Despite the fact that the data was not intended to shed light on indication of ultrasound or competency of ultrasound providers, in a healthcare world of shrinking reimbursement, as leaders of quality, we should ensure that ultrasound examinations that pregnant women receive are indicated and are performed by competent healthcare workers in ultrasound laboratories that meet accreditation standards.