OP19.09: Intracervical lakes as a sonographic marker of placenta accreta spectrum (PAS) in patients with placenta previa

To evaluate the role of a new ultrasound sign named “intracervical lakes” in predicting the outcome of PAS disorders. Retrospective multicentric study including all women with placenta previa > 26 weeks of gestation. Intracervical lakes, defined as tortuous anechoic spaces within the cervix hyper-vascular at Colour Doppler using a PRF < 1.3 KHz (figures 1a and b) were searched in all included women. The primary aim was to explore the diagnostic accuracy ofthis sign in detecting the presence and the depth of PAS disorders. The secondary aim was to explore the accuracy in predicting total estimated blood loss; antepartum bleeding; post-partum haemorrhage at the time of Caesarean Section; need for Caesarean hysterectomy. 332 women were included. Intracervical lakes were noted in 15.5% of them. At logistic regression analysis, intracervical lakes were independently associated with major post-partum haemorrhage (OR 3.3; 95% CI 1.6-6.51; p < 0.001), hysterectomy (OR 7.02; 95% CI 2.06-23.9; p < 0.001), placenta percreta (OR 2.78; 95%CI 1.34-5.77; p = 0.004). The association of at least one “typical” signof PAS and intracervical lakes had an OR of 217.17 (95% CI 27.69-1703.39; p < 0.001) for placenta percreta and of 687.37 (95% CI 121.37-3892.87; p < 0.001) for Caesarean hysterectomy. Supporting information can be found in the online version of this abstract Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.