Ultrasound Quarterly

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Ultrasound Quarterly:
doi: 10.1097/RUQ.0000000000000044
ACR Appropriateness Criteria

ACR Appropriateness Criteria® Second and Third Trimester Bleeding

Podrasky, Ann E. MD*; Javitt, Marcia C. MD; Glanc, Phyllis MD; Dubinsky, Theodore MD§; Harisinghani, Mukesh G. MD; Harris, Robert D. MD, MPH; Khati, Nadia J. MD#; Mitchell, Donald G. MD**; Pandharipande, Pari V. MD, MPH††; Pannu, Harpreet K. MD‡‡; Shipp, Thomas D. MD§§; Siegel, Cary Lynn MD∥∥; Simpson, Lynn MD¶¶; Wall, Darci J. MD##; Wong-You-Cheong, Jade J. MD***; Zelop, Carolyn M. MD†††



In the December 2013 issue of the journal, the copyright line of the article, “ACR Appropriateness Criteria Second and Third Trimester Bleeding” incorrectly was listed as “©2013 Lippincott, Williams, & Wilkins.” This was corrected to read © 2013 American College of Radiology for the online version of the journal.

Ultrasound Quarterly. 30(1):87, March 2014.

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Abstract: Vaginal bleeding occurring in the second or third trimesters of pregnancy can variably affect perinatal outcome, depending on whether it is minor (i.e. a single, mild episode) or major (heavy bleeding or multiple episodes.) Ultrasound is used to evaluate these patients. Sonographic findings may range from marginal subchorionic hematoma to placental abruption. Abnormal placentations such as placenta previa, placenta accreta and vasa previa require accurate diagnosis for clinical management. In cases of placenta accreta, magnetic resonance imaging is useful as an adjunct to ultrasound and is often appropriate for evaluation of the extent of placental invasiveness and potential involvement of adjacent structures. MRI is useful for preplanning for cases of complex delivery, which may necessitate a multi-disciplinary approach for optimal care.

The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every two years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.

© 2013 by Lippincott Williams & Wilkins



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