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Poster Session 3

Category: Clinical Obstetrics

Poster Session 3

(760) Delivery morbidity and obstetric outcomes associated with persistent basal plate myometrial fibers (BPMF)

Thursday, February 12, 2026

10:30 AM - 12:00 PM

Submitting Author and Presenting Author(s)

Cody Goldberger, MD (she/her/hers)

Resident
Department of Obstetrics and Gynecology, NYU Grossman School of Medicine
New York, New York, United States

Coauthor(s)

JL

Juliana Lindberg, BS

NYU Grossman School of Medicine
New York, New York, United States
PR

Patricia Rekawek, MD

Clinical Associate Professor, Department of Obstetrics and Gynecology
NYU Grossman Long Island School of Medicine
Mineola, New York, United States
TZ

Tatyana Zinger, DO

Department of Pathology, NYU Grossman School of Medicine
Long Island, New York, United States
EA

Esther Adler, MD

Department of Pathology, NYU Grossman School of Medicine
Long Island, New York, United States
PK

Poonam Khullar, MD

Department of Pathology, NYU Grossman School of Medicine
Mineola, New York, United States
AR

Ashley S. Roman, MD, MPH

MFM Division Director
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, NYU Grossman School of Medicine
New York, New York, United States
RJ

Rebecca H. Jessel, MD

Maternal Fetal Medicine Attending
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, NYU Grossman School of Medicine
New York, New York, United States

Objective:
Placentas with evidence of basal plate myometrial fibers (BPMF) have been referred to as occult accreta or micro-accreta. This histological finding of BPMF without intervening decidua is not infrequent and is often seen in clinically asymptomatic cases. There are conflicting data regarding the significance of these findings. The objective of this study was to evaluate obstetric morbidity at the time of the index delivery and in subsequent pregnancies for patients with evidence of BPMF.

Study Design:
We performed an observational study of pregnancies complicated by pathologic evidence of BPMF at a large, urban health system between 9/3/2013 and 5/1/2025. Patients without pathologic specimens and with incomplete medical records were excluded. Charts were reviewed for demographic information, risk factors for placenta accreta spectrum (PAS), obstetrical morbidity during the index delivery including postpartum hemorrhage (PPH) (defined as QBL of >1L), uterine sparing surgical therapy, additional procedures, and/or ICU admission, and subsequent pregnancy outcomes.

Results:
A total of 85 BPMF cases were identified. The median gestational age at delivery was 37 weeks. 88% of cases had at least one risk factor for PAS (Table 1). 27 deliveries (31.8%) were complicated by PPH, of which seven patients underwent peripartum hysterectomy. Of the 18 patients who had subsequent pregnancies, 14 carried at least one pregnancy to term, with no evidence of recurrent PAS at the time of delivery.

Conclusion:
In our cohort, BPMF was appreciated in patients with risk factors for PAS, suggesting that BMPF exists on a continuum with more severe abnormal placentation. Further, pregnancies with evidence of BPMF on pathology were at increased risk of PPH but were not at increased risk of recurrent PAS in subsequent pregnancies. Ongoing research is needed to better understand the evolving and possibly morbid diagnosis of BPMF.