We sat down with QUFW co-owner, Dr. Jackie Chua, to learn more about her unique contribution to obstetrics and gynaecology in Queensland, her passion for women’s health, the vision she has for QUFW, and more.
Dr. Jackie Chua is a RANZCOG-accredited sub-specialised Obstetrics and Gynaecology sonologist. She is currently the Head of Discipline in Obstetrics and Gynaecology for the Diploma of Diagnostic Ultrasound for the Australasian Society for Ultrasound in Medicine. She also represents Queensland on the COGU subcommittee at RANZCOG and the Australian Association for Obstetrical and Gynaecological Ultrasonologists committee. Dr. Chua has a special interest in fertility scanning and endometriosis assessment, and is the co-owner of QUFW.
Dr. Jackie Chua’s story is an inspiring blend of familial legacy, relentless self-education, and an unyielding advocacy for women’s health.
As we sit down to speak, it doesn’t take long for Dr. Chua to demonstrate why she has become an accomplished figure in Australia’s obstetrics and gynaecology space. Like many groundbreaking clinicians, her career ‘formula’ is unique. And it began with an origin story that started much earlier than her peers.
An early interest in obstetrics and gynaecology
Dr. Chua’s father, a medical school graduate from the University of Queensland, and her mother, a nurse from Toowoomba, instilled strong family values in their daughter from a young age. Moving from Australia to a small Canadian town when she was six months old, Dr. Chua was able to experience the colours of small-town medical life.
“When I was young, I would sit in the doctor’s waiting room waiting for my father, and I would sometimes hear ladies crying and screaming,” she recalls.
“But then every so often, I’d hear a baby.”
“And then, as I grew up, I thought, that’s very special.”
This backdrop of community care, and the vivid memories of experiencing the cries and joy of childbirth, sparked an interest in her future career.
However, despite these early influences, Dr. Chua’s path to medicine was not straightforward. After initially pursuing science in Canada, a family holiday back to Brisbane led to an impromptu, and successful, application to university.
Starting in pharmacy, she later transitioned into medicine and completed her medical training at the University of Queensland. An internship experience in an obstetrics and gynaecology (“O&G”) placement at the Mater hospital appealed to her.
“I liked obstetrics and gynaecology because it gave me a mix between medicine and surgery,” she explains.
“And I thought, well, that’s cool. You are able to use surgical skills and medical skills, rather than having to think you have to just do ‘medicine’ or you just have to do ‘surgery’.”
“And I felt that there must be somewhere I can actually actually help people, especially women, so that they understood their health better and weren’t scared by their bodies.”
“That’s why I wanted to do O&G when I graduated,” she explains.
“After doing my internship at the Mater, I decided to go and do my second year at Southampton General Hospital in the UK.”
Early career, inspiring role models
It was at this time in her career that Dr. Chua was influenced by two inspirational clinicians.
“At that time, one of the doctors I knew of was Dr. Aldo Vacca. He’s the gentleman who invented what’s called the Kiwi Cup, a vacuum suction cup for delivering babies.”
“He gave back to charity, went back to PNG and worked there every so often, and invented a vacuum extraction device that makes deliveries safer and better.”
“He unfortunately passed away quite a few years ago, but he was amazing,” Dr. Chua explains.
Dr. Chua also recalls her admiration for the late Professor Fung Yee Chan, a no-nonsense, fiercely intelligent female clinician who was the founder of, and a role model in, a department that was predominantly male at the time.
“She was no nonsense and she was smart. She was very dedicated. She was someone that you just sit and go, wow!”
“As a female doctor in a position of that type of departmental type of position, it was really cool because everyone at that time were actually all boys,” she explains.
When Dr. Chua returned to Australia, she embarked on a six-year O&G training program. Her decision to sub-specialise in ultrasound was sparked during her fifth year, after the program’s curriculum opened her eyes to the possibilities within the field.
When she completed her training, Dr. Chua found herself as the only COGU subspecialist in Queensland—a distinction she held for over a decade.
A graceful attitude towards patient care
Dr. Chua doesn’t rush appointments, despite the pressures of a busy clinic, and she is attentive to the underlying fears that might accompany a patient’s visit.
“I just stop and I listen,” she says.
“And I go back and say… look, I understand what you’re saying.”
“And please don’t feel like you can’t ask me a question. I will always listen.”
She explains her use of empathy as both a clinical tool and an instrument for putting her patients at ease.
“And I try to find out what it is that they’re scared of as well, which can be very relieving once they open and up and discuss it.”
This holistic approach to patient care—balancing technical expertise with compassionate communication—is undoubtedly one of the traits that have contributed to her career trajectory.
When probed for a feel-good patient story, Dr. Chua, with a chuckle, admits the challenge in articulating a single moment. To her, each patient is a chapter, and while she may be a crucial part of their healthcare journey, the collective gratitude expressed by those she helps stands out more than any one experience.
“Some patients stop and just say thank you. Thank you for explaining it well. I didn’t understand. Thank you for actually listening or taking the time and explaining it,” she says.
Helping women understand their bodies
One of Dr. Chua’s passions is helping women understand, and not fear, their bodies.
She does this by delivering definitive diagnoses as best she possibly can, particularly in complex conditions like endometriosis. She tries to offer patients not just medical insights but also validation and relief from the angst of the unknown.
“Some ladies feel frustrated when their pain goes undiagnosed.”
“In my work in gynaecology, I’m sometimes able to say to some ladies that, yes, there is something wrong with you, even if other avenues haven’t been able to visibly see anything,” she explains.
“It gives patients the realisation that their pain is real.”
She considers herself a link in the healthcare chain, aiding fertility specialists by advising on the viability of natural conception or the need for IVF, assisting gynaecologic oncologists by identifying potential cancers, and ensuring that fetal abnormalities are appropriately managed through collaborative care.
Dr. Chua is humble and reluctant to celebrate her career. Yet the significance of her role transcends the technicalities of her specialty.
The limitations of ultrasound
Dr. Chua is also eager to address a common misunderstanding of medical ultrasound technology: while ultrasound is adept at revealing structural aspects of the body, it cannot ascertain functionality.
This limitation is a frequent source of misunderstanding among patients who seek absolute reassurance about their health, or the health of their unborn child.
“Patients often come with the hope of hearing that everything is perfect,” she explains.
“They say, ‘all I want is a healthy baby,’ and naturally so.”
“But the reality of what ultrasound can deliver in terms of answers is sometimes at odds with these expectations.”
She confronts the difficult task of conveying that, while she can identify the presence of vital organs and limbs, the ultimate functioning of these structures remains beyond the scope of the scan. Her clinical process becomes a delicate combination of providing clear information and managing patient expectations.
Additionally, in the world of gynaecology, Dr. Chua faces similar challenges. Women suffering from years of pelvic pain may expect a definitive diagnosis through ultrasound, which is not always possible.
“Ultrasound, on its own, is not meant to definitively diagnose conditions like endometriosis,” she asserts.
The task then becomes one of education, helping patients to understand that while ultrasound is a powerful tool, it has its bounds.
On professional and clinical developments
In discussing how she keeps herself and her clinic at the cutting edge, Dr. Chua reveals a commitment to continuous learning, jokingly referring to ‘osmosis from her peers’ before delving into more substantial methods.
“That’s why I like to teach. I like to learn. I always say… I’m not done learning.”
“At least I’m done having exams. At least I think I am,” she chuckles.
“But I don’t think I know everything and I’m always happy to learn.”
Dr. Chua’s approach to medicine is dynamic; she sees every procedure as a collective effort, influenced by various practitioners, where learning and teaching are reciprocal processes.
She maintains an affiliation with the public hospital system, not solely for the sake of helping more people but also to teach and learn from others.
Looking towards the future, Dr. Chua hopes to continue enhancing the standards of ultrasound in women’s health by building on the clinic’s achievements and fostering an environment of continuous improvement.
The future of her practice
Dr. Chua is passionate about QUFW’s future, ensuring the clinic’s longevity by welcoming junior fellows without overwhelming them. She envisions a collaborative future, not just within her immediate team of sonographers but extending into the wider medical community, including GPs, to optimise care for women.
What sets QUFW apart, in Dr. Chua’s view, is her team’s approachability and willingness to engage in dialogue. She believes in maintaining open lines of communication, where questions are welcomed, and answers are given thoughtfully—a philosophy that may be understated but is deeply valued.
Dr. Chua jumps at the chance to describe her team as exceptionally skilled.
“They’re darn good at what they do and I feel like I’m the support act sometimes to them, but hopefully, I’m a good support act,” she says.
In ten years from now, Dr. Chua sees QUFW growing and evolving while retaining the core team that makes it exceptional. Her modesty is clear when discussing the clinic’s success, highlighting her preference for service over self-promotion.
When asked about the next decade, she says she hopes QUFW will be, “slightly bigger, slightly older, and still with the great team.”
“And just continuing to work hard.”
A doting family figure
Dr. Chua finds solace in family life, allowing the comforts of home to provide rejuvenation. She emphasises the importance of leaving work at the door–a strategy to preserve her own well-being amidst the demands of her career.
“I do try to leave it at the doorstep and, if occasionally it does come home with me, that’s fine,” she says.
In a final reflection on her career, Dr. Chua considers the possibility of maintaining her surgical skills but ultimately expresses contentment with her chosen path, affirming that specialising has allowed her to excel in her field.
If she could offer her younger self a piece of advice, it would simply be, “you’ll get there,” a nod to the patience and perseverance that have been hallmarks of her journey in medicine.
As the interview concludes, Dr. Chua’s gentle, confident, yet humble nature is evident. Her pioneering spirit, commitment to her work, and the care of her patients and team speaks louder than any self-praise.
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March 2024
Content Disclaimer
The information provided on this website is for educational and informational purposes only. It is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment and before undertaking a new healthcare regimen.
The content on this website is not intended to be a comprehensive source of information on any particular topic and should not be relied upon as such. The authors and publishers of this website are not liable for any damages or injury resulting from the use or misuse of the information provided on this website.
Placenta accreta spectrum is a potentially life-threatening obstetric condition where the placenta grows too deeply into the wall of the uterus. This abnormality may prevent the placenta from detaching after childbirth, causing significant maternal bleeding and other complications for both the mother and her baby.
Placenta accreta was traditionally classified into different types based on the severity and depth of placental invasion (accreta, increta and percreta). Often, however, the only way to determine this is after delivery. As a result, all disorders of abnormal placentation are now referred to collectively as placenta accreta spectrum (or PAS)
PAS is often diagnosed during pregnancy through ultrasound, although it may sometimes only be detected during delivery. It requires advanced diagnosis and careful management by a multidisciplinary medical team.
‘Placenta accreta spectrum disorder’ (PAS) is a pregnancy-related condition where the placental villi abnormally invade the myometrium during the first trimester of pregnancy.
Normally, the placenta separates from the wall of the uterus after childbirth. However, in cases of PAS, this detachment does not occur as it should.
Animated portrayal of placenta accreta spectrum (PAS) – John Hopkins Medicine
A study covering Australia and Aotearoa New Zealand found that the occurrence of PAS is around 44.2 in every 100,000 women (or 1 in 2000) who are giving birth, although there are some risk factors which make PAS much more likely in some patients.
What are the different types of PAS?
PAS is classified into three types based on the depth of placental invasion into the wall of the uterus. This differentiation can only definitively be made after delivery, on histopathological assessment.
Placenta accreta: This is the most common. In placenta accreta, the placenta attaches itself deeply into the uterine wall but does not penetrate the muscle of the uterus. This can lead to difficulties in placental detachment during childbirth.
Placenta increta: In this form, the condition is more severe. The placenta invades into the muscles of the uterus, embedding itself more deeply than in placenta accreta. This increases the risk of severe bleeding during delivery and can pose more significant health risks.
Placenta percreta: This is the most severe form of the condition. In placenta percreta, the placenta penetrates through the entire uterine wall and can attach to other organs, like the bladder or intestines. This type poses the highest risk of severe complications, including severe bleeding, and may require extensive surgical intervention, and earlier delivery.
The severity and extent of PAS significantly impacts the approach to delivery and the type of medical intervention required. Early and accurate diagnosis is essential for managing these risks and planning a safe delivery strategy.
PAS is typically diagnosed through a combination of imaging tests and clinical assessment. The most common diagnostic methods include:
Ultrasound: Ultrasound is the first line imaging modality for diagnosing PAS. A detailed ultrasound can show abnormal placental attachment and blood flow. Doppler ultrasound, which visualises blood flow, can be particularly useful in identifying unusual blood vessels that may suggest the presence of PAS.
Magnetic Resonance Imaging (MRI): If ultrasound results are inconclusive or if a more detailed view is needed, an MRI can be used. MRI has similar sensitivity in detection of PAS as ultrasound, but can be useful when ultrasound is limited (e.g. in higher BMI, or when the placenta is posterior) .
Clinical History and Risk Factor Assessment: A thorough assessment of the patient’s medical history, including previous caesarean sections, uterine surgeries, and other risk factors, is important. This information (also known as the pre-test probability, or likelihood), combined with imaging results, helps in making a diagnosis.
Early diagnosis is crucial for planning appropriate medical care to manage the condition and reduce the risk of complications during delivery. Women with known risk factors for PAS are typically monitored more closely with these diagnostic tools, and an accurate antenatal diagnosis of PAS impacts delivery planning.
Placenta praevia completely covering the internal cervical os with placenta accreta
What risk factors may contribute to PAS?
There is some thought that PAS may be a later gestation manifestation of caesarean-scar pregnancy, or a pregnancy which implants within the prior caesarean scar. Rather than being an abnormality innate to the placenta itself, the abnormal invasion and development of the placenta may relate to the location in which it implanted, and the nature of the scar tissue.
PAS is known to be associated with several risk factors, each contributing to the increased likelihood of its occurrence:
Previous Caesarean Delivery: A history of caesarean delivery is a major risk factor for PAS. With each subsequent caesarean, the risk of PAS increases. This is because the surgical scar in the uterus can be a site where the placenta abnormally adheres in future pregnancies.
Low-Lying Placenta or Placenta Previa: When the placenta is positioned low in the uterus or covers the cervix (placenta previa), the risk of PAS is higher. This abnormal positioning can lead to a deeper implantation of the placenta into the uterine wall. However, placenta accreta spectrum is still relatively rare in placenta praevia, unless a patient has also had prior caeasarean sections.
Advanced Maternal Age: Women who are older, typically over the age of 35, have a higher risk of developing PAS.
Multiparity: Having multiple pregnancies increases the risk of PAS.
Previous Uterine Surgery Including Myomectomy, D&C, Cornual Resection, or Endometritis: Any previous uterine surgery, such as the removal of fibroids (myomectomy), dilation and curettage (D&C), cornual resection, or a history of endometritis (inflammation of the uterine lining), can leave scars or changes in the uterus. These alterations can create areas where the placenta can attach too deeply, increasing the risk of PAS.
Transvaginal ultrasound image demonstrating placenta praevia with suggestion of placenta increta. Bladder wall appears intact.
What are the symptoms of PAS?
PAS often does not present with multiple distinct symptoms, especially early in pregnancy, which is why it is frequently diagnosed through routine imaging in at-risk patients. However, there are a few signs and symptoms that may suggest the presence of PAS, particularly as a pregnancy progresses:
Vaginal Bleeding: This is the most common symptom and usually occurs in the second or third trimester of pregnancy. The bleeding can range from light to heavy.
Fetal malpresentation: The baby may persistently remain in a non-cephalic (breech or transverse) position because the abnormally implanted placenta (when covering the cervix) prevents the baby descending in the pelvis.
It’s important to note that many women with PAS do not experience any noticeable symptoms, and the condition is often detected during routine prenatal imaging in women who have risk factors for the condition.
What are the risks associated with PAS?
PAS carries several significant risks and potential complications, mainly due to the abnormal attachment of the placenta to the uterine wall. These risks can impact both the mother and the baby:
Severe Maternal Haemorrhage: This is the most significant risk. The deep attachment of the placenta can lead to severe bleeding during attempts to remove the placenta after childbirth. This can result in a life-threatening situation requiring immediate medical intervention.
Need for Hysterectomy: Most commonly, a hysterectomy (surgical removal of the uterus) is necessary following delivery, as the placenta will not detach from the uterine wall.
Preterm Birth: PAS can increase the risk of preterm labour and delivery, which carries risks for the baby, including respiratory distress syndrome, developmental delays, and other prematurity-related complications. This can be either iatrogenic (planned preterm birth to reduce potential complications), or spontaneous, in which case delivery may be indicated in the scenario of a large bleed.
Blood Transfusions and Surgery: Due to the risk of severe bleeding, blood transfusions and multiple surgical interventions may be required.
Damage to Other Organs: In severe cases, particularly in placenta percreta, the placenta can invade other organs like the bladder or intestines, leading to additional complications and the need for more complex surgery.
Mental Health Impact: The diagnosis and management of PAS, including the potential loss of fertility and the stress of a high-risk pregnancy, can have significant emotional and psychological impacts.
For the baby, the risks are mainly associated with premature birth and the potential complications that can arise from being born early. There is also a risk of fetal growth restriction associated with placenta accreta spectrum, and this is why serial ultrasound is recommended to monitor fetal growth.
Transvaginal ultrasound image demonstrating colour flow in placenta accreta.
How is PAS treated?
The treatment of PAS primarily focuses on managing the risks during childbirth and addressing potential complications, especially severe bleeding. The treatment plan depends on the severity of the condition, the health of the mother and baby, and the stage of pregnancy.
Common treatment strategies include:
Planned Caesarean Hysterectomy: Women with PAS will be recommended to deliver by planned caesarean section. This is often planned around 34-36 weeks of gestation, to minimise the risk of spontaneous labour, which could lead to uncontrollable bleeding. In most cases, with the exception of small focal placenta accreta spectrum, a hysterectomy (removal of the uterus) is planned as a part of the same operation and performed immediately after the delivery of the baby. This is often necessary to control bleeding and can be a life-saving measure.
Blood Transfusions: Due to the high risk of severe bleeding, arrangements for blood transfusions are usually made in advance of the delivery.
Medication Management: Medications may be used to control bleeding, manage pain, and prevent infection during and after the delivery.
Follow-up Care: Postpartum care is crucial, especially if a hysterectomy is performed. Monitoring for complications like infection, bleeding, or psychological impact is important.
Each case of PAS is unique, and the treatment plan is tailored to the individual’s specific situation. Early diagnosis and careful planning are key to the successful management of PAS.
Will I need a Caesarean section if I have PAS?
If you have PAS, a caesarean section will be recommended for delivery. This is because the abnormal attachment of the placenta to the uterine wall in PAS makes it impossible for the placenta to separate naturally and safely during vaginal delivery. Attempting a vaginal birth in such cases could lead to severe, life-threatening bleeding.
In many cases a hysterectomy (surgical removal of the uterus) will be planned immediately after the delivery of the baby during the same surgical procedure. This is done to control bleeding and is often a necessary step in managing the condition.
It’s important to discuss your specific case with your healthcare provider, who can advise on the best approach for delivery based on the extent of the PAS and your overall health. They will also consider other factors, such as whether the PAS is considered likely to be focal (a small area which may be able to be resected) or more diffuse.
Can PAS be prevented?
Preventing PAS can be challenging because the exact cause of the condition is not entirely understood. However, there are certain measures and considerations that can help reduce the risk:
Limiting Caesarean Deliveries: Since a major risk factor for PAS is previous caesarean deliveries (Caesarean sections), limiting the number of Caesarean sections when medically possible can reduce the risk.
Careful Management of Uterine Surgeries: Procedures that involve the uterus, such as myomectomy (removal of uterine fibroids), can increase the risk of PAS in future pregnancies. This is more the case when fibroidectomy is cavity breaching.
Early Prenatal Care: Early and regular prenatal care is important, especially for women with risk factors for PAS. Early detection of potential issues allows for better planning and management.
Family Planning and Birth Spacing: Thoughtful family planning and spacing between pregnancies can help minimise the cumulative risk associated with multiple pregnancies and Caesarean sections.
Can I still have a vaginal birth with PAS?
Most cases of placenta accreta spectrum also occur in the setting of a low lying or praevia placenta, which will often prevent descent of the baby into the birth canal to allow a vaginal delivery.
Additionally, when the placenta is abnormally adherent, even if the baby can be delivered vaginally, the PAS will prevent placental separation warranting operative management following delivery to manage bleeding and retained placenta.
The information provided on this website is for educational and informational purposes only. It is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your obstetric doctor or other qualified provider with any questions you may have regarding a medical condition or treatment and before undertaking a new healthcare regimen.
The content on this website is not intended to be a comprehensive source of information on any particular topic and should not be relied upon as such. The authors and publishers of this website are not liable for any damages or injury resulting from the use or misuse of the information provided on this website.
From a young age, Kate knew she wanted a family. But what she didn’t know then, was the journey to motherhood would be more complicated than expected. After experiencing miscarriages previously, Kate and her husband Aaron were nervous when they got pregnant again, but were relieved when they found out that baby Ruby had a heartbeat! With the finish line in sight, at their 36 weeks scan, the pair faced a new hurdle when they were told that their baby girl may not live a full and healthy life. However, thanks to new and improved ultrasound technology Dr. Robert Cincotta, Maternal Fetal Medicine Specialist, and the team at Queensland Ultrasound For Women were able to detect her intracerebral bleed and make an early diagnosis.
This video was produced by BBC StoryWorks Commercial Productions on behalf of GE HealthCare.
We sat down with QUFW’s Clinical Educator, Simone Karandrews, to learn more about her inspiring journey as a women’s health sonographer, her role as a clinical and career mentor, and the changes she’s making in the community
Simone Karandrews is the Clinical Educator at QUFW. She has more than 28 years’ experience in the diagnostic imaging sector.
Simone’s story as an experienced sonographer and community change-maker is as unique as it is inspiring.
As she delivers her answer to the classic ‘tell me how your career started’ question, it quickly becomes obvious why Simone holds so much respect across her clinic, industry, and community.
Simone is a skilled clinician, with more than 28 years’ experience in diagnostic imaging. She tells fascinating stories, both happy and sad, about her journey as a sonographer.
But what sets Simone apart is her passion—for helping others, for creating positive change, and for the lifechanging outcomes sonography provides far beyond the scanning room.
This is where her story takes a different path. Unlike some, Simone’s interest in sonography didn’t ignite during a university lecture or career workshop. Instead, it captivated her for the first time in a more unusual setting: piano lessons, during her late school years.
“When I was in school, I took piano lessons with a wonderful old piano teacher,” Simone recalls.
“There was another student whose mother was a sonographer, which was quite rare at the time. My piano teacher used to talk to me about her and her role.”
“And so I met up with her when I was on work experience in medical imaging in year ten, and obviously I was able to watch her scan.”
Simone explains what she felt as she saw an ultrasound scan for the first time.
“I remember how in awe I was, that this woman could know what she was looking at, what she needed to look at, what other things she may need to look at, and why,” she explains.
“With ultrasound, you’re like a detective using great technology to make a difference to people’s lives.”
“It was a combination of technology and medicine all in one”, she says.
An official introduction to sonography
Simone was officially introduced to clinical ultrasound during placement at a local hospital.
“My first work experience placement was in nuclear medicine at one of the local hospitals in Canberra,” she explains.
“And, as I mentioned, as part of my rotation there, I was able to see an ultrasound being performed.”
“And for me, that was it, I was hooked.”
“That’s where I wanted to end up,” she says with a sense of nostalgia.
Deciding to pursue this career path, Simone studied a Bachelor of Applied Science in Medical Radiation, specialising in nuclear medicine at the University of Sydney.
As her graduation approached, a radiology company in Queensland reached out, flying her interstate for an interview.
By the end of the day, Simone had a new job and a new city to call home.
“I remember ringing my dad from the Brisbane Queen Street Mall saying, I’m taking the job.”
”But, I’d never been to Brisbane. I didn’t have any family here, didn’t have any friends here.”
“So it was a leap into the great unknown,” she reflects.
“There was a lot of personal growth for me and change at the same time, but it was all a big adventure.”
Simone gathered experience in some of Queensland’s busiest medical hubs. She was quickly recognised as a rising star in nuclear medicine, and was offered a spot in a rigorous training program and post-graduate Diploma in Medical Ultrasound at QUT.
During this time, Simone was introduced to various facets of ultrasound, including training in women’s imaging clinics. Here, she found her niche—breast ultrasounds, gynaecology, and obstetrics.
“I felt much more comfortable with obstetrics and gynaecology, and I think that that’s really what laid the foundation for me and my passion.”
Simone’s current role
Fast forward two passionate decades, and Simone is now the Clinical Educator at QUFW.
In this role, she trains and mentors QUFW’s junior sonographers and helps ensure high clinical standards and continuing education across all four practice locations. Simone also enjoys scanning patients in QUFW’s Brisbane and Ipswich practices.
Whilst the Clinical Educator role involves teaching traditional ‘hands-on’ skills, it also requires Simone to lead by example and personify the unwritten qualities of an impactful sonographer: clinical excellence, a warm bedside manner, a thirst for knowledge, and all of the other things that helps QUFW deliver the exemplary care it is known for.
It should come as no surprise that Simone is thriving.
“I feel fulfilled that I am in a great role,” she says.
“I have great support networks and some wonderful colleagues surrounding me.”
“And this allows me to continue my desire to learn new things and help others.”
“I think it’s important to keep learning, to keep life interesting.”
She also feels grateful to work with fellow sonographers who share her work ethic, mentioning how they feed off each other’s dedication and expertise.
“The sonographers that I work with also have a very similar work ethic.”
“And working in that way, we work really well together.”
“We all are there for each other, and collaborate and assist each other,” she says.
The joy of touching lives
Simone explains how the beauty of sonography lies in the privilege of helping people experience life’s cherished moments.
“It’s a privilege to be a part and parcel of people’s health journeys,” she says.
“Ultrasound is a fantastic way for families to bond with their new unborn baby.”
Simone recalls a patient story that left an indelible mark on her heart.
“I remember a patient, Rosanna, coming to our practice for the first time, and she was about seven weeks pregnant,” she explains.
“She is a GP, so she knew what to expect.”
“We scanned her, and discovered that she was having twins, actually MCMA twins, which are extremely rare,” she explains.
“And I remember her looking at the screen, and she’s having this quiet… well, not so quiet panic attack, knowing what she was looking at and her poor husband who’s not medical, was asking, what’s the problem?”
“And she’s trying to explain to him what’s happening, walking him through the diagnosis side of things, but also managing her anxiety and excitement at the same time.”
“We developed a closer relationship, because we got to see Rosanna so frequently.”
“And that was really lovely. Just like with our other patients that we get to see over the course of their journey.”
Both babies were delivered safely, and are now thriving. Simone was ecstatic to meet them and, of course, be part of their origin story.
“And to know that this family ended up with a great outcome with two beautiful healthy girls in such a rare pregnancy, which had so many potentials for a poorer outcome, was just wonderful,” Simone says.
Watch more here:
The challenging times
However, it’s not always about joyous occasions. Simone opens up about the challenging moments, like delivering the heartbreaking news of a miscarriage.
But even in these trying times, she focuses on providing individualised, compassionate care, ensuring patients feel supported and receive appropriate follow up with doctors.
“You might see people on the worst days of their lives,” she says.
“During the scan, for instance, we may discover a miscarriage or an abnormality and we have to impart that information to those patients.”
“The challenge is being able to try and do that the best way possible.”
Simone pauses and reflects on some of the feedback she has received after delivering bad news.
“For people who have just received awful news, they are trying to absorb information and grieve all at once. But when they make the effort to say thank you for being so kind and compassionate, I feel as though I’ve done the best I possibly can given the nature of their situation.”
Passing on her knowledge
Simone thrives on her role as a mentor, shaping the essential hard and soft skills of the sonographers of tomorrow. She relishes in their achievements, likening this to the highs of parenthood.
“Sharing knowledge and being able to tutor the sonographers of tomorrow, shaping their skills and setting them up for a good, strong career is so important.”
“I like being part of their learning journey, and I feel like a proud mum when they actually realise their goals,” she says with a smile.
“I really do get a kick out of seeing them become the developed sonographer that they are hoping that they can be.”
Simone also has sage advice for budding sonographers.
“I would say to them that it’s a really rewarding career.”
“Finding your passion within the many facets of ultrasound specialty is really important.”
“It’s such an interactive profession with so much patient interaction. It’s a skill to bring pieces of information together to assist in making a diagnosis.”
This statement isn’t just a career catchphrase for Simone—it is built around her belief that the quality of an ultrasound scan relies heavily on the skills of the sonographer.
Emphasising the sonographer
A good scan requires an attentive eye, adept hand-eye coordination, a strong connection with patients, an understanding of anatomy and physiology, and a deep knowledge of the technology at hand, Simone says.
“Ultrasound can be used widely across so many different areas of the body, but the one thing that I’d really like to highlight is the fact that its strength is definitely in the hands of the sonographer.”
“It’s as much science as it is art.”
“There is so much visual recognition, hand-eye coordination, ability to drive the machine, talk to patients, communicate, draw information from them, that can actually really help with providing an accurate diagnosis,” she says.
Simone also highlights the importance of effective communication, empathy, and active listening.
In Simone’s eyes, an effective ultrasound scan requires an intricate blend of science, art, and human connection. It’s a field where the expertise and intuition of the sonographer play a crucial role, turning a standard scan into a precise diagnostic tool through visual acumen, technical skill, effective patient communication, and a deep sense of empathy.
Personal and political passions
Aside from her role as a sonographer, Simone is an active member of her community. She’s involved in the West Moreton Darling Downs Primary Health Network, where she plays a role in bridging the gap between the community and healthcare providers. She is also responsible for forming and coordinating a community led disaster support group to assist her community in times of natural disasters.
Simone has also been a part of the Australian Sonographers Association Committee for Queensland for over 20 years, showing her dedication to peer education and overall advancement of the profession.
“I’m genuinely interested in healthcare outcomes for people, which is all about how people actually access healthcare within the region, as well as assisting in skill advancement for other sonographers,” she says.
Outside the clinic, Simone seeks solace in the company of her family, including her retired racing greyhound, Alice. Her love for nature, photography, and baking serves as her personal retreat from the demanding nature of her job.
But there’s another facet to Simone that might surprise many: politics. In 2019, driven to address regional issues she felt were being ignored, she took a plunge into federal politics as a candidate in the election.
Although she didn’t achieve the resolution she sought, Simone’s political journey led her to be part of the inaugural cohort of the Pathways to Politics Course in Queensland, empowering women to change the political landscape.
“It all came about because I’ve been pushing a particular campaign to do with an issue in our region.”
“And I didn’t feel as though we were really being represented very well to seek a resolution that would make a real difference to the people and businesses within the community. But it became more than about just one issue – it was about being a genuine voice for community and future outcomes.”
Looking back and forward
Reflecting on her career, Simone is content with her choices. She wouldn’t change a thing.
Her parting wisdom is an echo of QUFW’s philosophy, ‘experience really does matter’.
“And I say that, because our team is invested in our patients.”
“We aim to be the leaders of what we do,” she says.
When asked if she’d do anything differently throughout her career, her answer is clear:
“No, nothing. I’m happy.”
For Simone, sonography is so much more than a diagnostic tool. When she picks up the transducer, she’s helping one patient. But when Simone mentors her students and pushes for change in her community, she’s using her clinical and social skills to change the lives of so many more.
Simone’s journey is one of passion, excellence, and an unyielding intention to change things for the better. If you’re a patient in Simone’s ultrasound room, a sonographer under her wing, or a member of her community, you’re luckier than you might realise.
–
November 2023
Content Disclaimer
The information provided on this website is for educational and informational purposes only. It is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment and before undertaking a new healthcare regimen.
The content on this website is not intended to be a comprehensive source of information on any particular topic and should not be relied upon as such. The authors and publishers of this website are not liable for any damages or injury resulting from the use or misuse of the information provided on this website.
We sat down with QUFW co-owner, Dr Robert Cincotta, to learn more about his journey as a medical practitioner, his remarkable contributions to obstetrics, his vision for QUFW, and more.
Associate Professor Robert Cincotta is an obstetrician and subspecialist in maternal fetal medicine. His major interests are in fetal therapy, prenatal diagnosis and the management of complicated pregnancies. Dr Cincotta is the co-owner of QUFW.
As we sit down to interview Dr Cincotta, he wastes no time demonstrating his signature passion for obstetrics.
When asked about the beginning of his career, his eyes light up.
“When I saw my very first delivery, I just couldn’t believe how wonderful it was. I fell in love straight away with the whole area. And I absolutely loved how I saw the doctors and the midwives looking after women who are pregnant, and the problems they faced,” he says.
Born, raised, and initially medically-trained in Melbourne, Dr Cincotta was introduced to obstetrics during early rotations as a medical student. Witnessing his first delivery was one of those “life-changing” experiences that he’ll likely never forget, he says.
It’s where he fell in love with obstetrics – a discipline that presented him with both joys and challenges. And while most deliveries were smooth, he was intrigued by the complications that sometimes arose.
“The people who were involved had to be able to know what to do. And as soon as I could, I began my training to become an obstetrician. And then I just absolutely loved it.”
Finding his niche in complicated pregnancies
As his journey progressed, Dr Cincotta discovered that his passion lay in managing complicated pregnancies. One particularly challenging condition that captured his attention was twin-to-twin transfusion, where identical twins share a placenta, leading to a dangerous transfer of blood between them.
With limited knowledge and treatments available at the time, Dr Cincotta was successful in becoming one of Australia’s first trainees in maternal-fetal medicine. Following training stints in Melbourne and London, Dr Cincotta found himself in Brisbane, where he would make significant contributions to the field.
Pioneering a groundbreaking, life changing treatment
In Brisbane, at the Mater Mothers’ hospital, Dr Cincotta began research into existing treatments for twin-to-twin transfusions, being implemented on foreign shores. Determined to bring them to Australia, he collaborated with renowned medical experts like Ruben Quintero, even using early video conferencing technology to learn from overseas surgeries in real-time.
“About 22 years ago, we did the first laser for twin-to-twin in Australia. Then, we started getting people from all around the country. And our results were as good as anywhere around the world at that time.”
“And so we set that service up for the Mater. And then other centres around the country started to be established, and now it’s a standard treatment for this condition.”
Thanks to Dr Cincotta’s efforts, laser treatment for twin-to-twin transfusion was introduced in Australia. This procedure involves using a device in the uterus to ablate the blood vessels connecting the twins. With this innovative technique, the outcomes improved dramatically for such pregnancies.
Dr Cincotta recalls one of his most memorable early treatments.
“We had a case of twin-to-twin that developed when I was down at the Gold Coast. At 26 weeks [the patient] developed this [condition] quite quickly, and the babies looked quite unwell.
“And I could recall seeing cases like this 10 years beforehand when there wasn’t a treatment, and we’d often have to deliver these babies and they’d often do incredibly poorly. But I was able to organise for [the patient] to have a laser that afternoon. The babies made a complete recovery and she delivered at about 33 weeks.”
“And every year or so she comes along and shows us the two little girls.”
“It’s just really humbling when you see things like that, and makes me so grateful for how it happened,” he beams.
The move to ultrasound, and the origins of QUFW
Recognising the critical role of ultrasound in managing pregnancy complications, Dr Cincotta took another pivotal step in his career. Concerned about the quality and interpretation of ultrasound, especially outside major city centres, he established Queensland Ultrasound for Women (QUFW).
“Ultrasound is so critically important in the management of pregnancy complications. And one of the things we always knew or saw was that in the big city centres, the quality of ultrasound is very operator dependent and more importantly, the interpretation of what we’re seeing was very dependent upon the experience of the people reporting it.”
“We always wanted to improve the general quality of ultrasound, and particularly pregnancy ultrasound.”
“I always wanted to set up a service to provide high quality ultrasound to as many people as we could.”
“And so 18 years ago we set up Queensland Ultrasound for Women.”
Starting in Brisbane, QUFW has expanded its reach to several parts of Southeast Queensland, ensuring that women receive high-quality ultrasound services.
Beyond the technical aspects, Dr Cincotta emphasises the importance of counselling and support. He believes that when problems arise, women should not only get a diagnostic report but also have a compassionate expert to explain, guide, and reassure them.
“And more importantly, when there’s problems, to be able to actually counsel those women and talk to them at the time, and to try and provide as good a service as we possibly can.”
Charting breakthroughs in genetic testing and screening
One of the most significant advancements Dr Cincotta has seen recently is in the arena of genetics and DNA. Breakthroughs like NIPT (non-invasive prenatal testing) allow for the identification of chromosomal and genetic problems, revolutionising the way doctors approach prenatal care. The introduction of genetic carrier screening provides even more opportunities to identify potential conditions.
“In the past, you’d see a baby with problems, and often, it might be an extremely rare condition,” Dr. Rob explains.
Today, technological progression means many of these conditions, no matter how rare, can be identified much earlier, and sometimes even treated.
“When I started doing obstetrics, I’d do lots of amniocentesis procedures. For example, I’d do 60 amnios and there’d be only one baby with major chromosome problems. Unfortunately, the downside of doing amnios is the risk of miscarriage, so there’s a lot of unnecessary procedures and risk incurred for only one baby with problems.”
“Then they worked out that looking at the fluid behind the back of an unborn baby’s neck was a good predictor for chromosome problems. If you use that as a screening tool and then base the invasive testing on the thickness of the fluid rather than just on age alone, it went down to an abnormal result of about one every 15 amniocentesis procedures.”
“So this decreased the number of invasive procedures we had to do.”
“And they improved it further by adding blood hormone levels, the biochemistry in it, and that made it about one in 10 or 8 positive results.”
“Then the NIPT test came along about six years ago and that changed everything. The number of amniocentesis procedures we had to do dropped by about three quarters.”
“It really had a dramatic effect.”
“So NIPT changed what we do. And now they’re picking up even less common, rarer conditions, but it can be quite significant. The detail we can get at 13 weeks is incredible.”
Gearing up for the future: AI integration and advanced tech
The future looks even brighter. As Dr Cincotta hints, newer and more advanced ultrasound machines are on the horizon, promising leaps in quality. He is particularly excited about the integration of AI into ultrasound technology.
“We’re hopefully going to get the latest machines coming in, in the next few months. And there’s a huge jump up with the quality, it’s amazing.”
“And also, we’re starting to see AI being implemented into ultrasound machines, into the software, and we’re already seeing that they can anticipate what we’re actually looking at and they can do measurements, labelling, and things like that.”
“It’s not going to get rid of us, but it will allow us to scan more efficiently and with more detail. And I think that’s going to be an incredibly exciting time.”
Mentoring the next generation
One of the hallmarks of Dr Cincotta’s career has been his dedication to training. Whether it’s through his longstanding affiliation with the College of Obstetrics and Gynecology, where he notably served as the chief examiner, or his personal endeavours, Dr Cincotta has always believed in sharing knowledge.
When asked about his advice for medical students, Dr. Cincotta’s enthusiasm is contagious. He believes medicine, particularly his field, is “the best job in the whole world.”
“I’ve been lucky enough to train people in maternal-fetal medicine over the years, and they’ve gone on to be leaders in their own way,” he says.
He fondly recalls setting up a training service for registrars at the Gold Coast, offering them an exclusive three-month stint in ultrasound—a rarity in most places around the country. Beyond doctors, he has also been instrumental in training sonographers, emphasising the importance of holistic care in maternal-fetal medicine.
For Dr Cincotta, it’s more than just imparting knowledge. It’s about ensuring the continued high quality of service for mothers and their babies. “It’s trying to spread that to other people,” he notes, highlighting his belief in making sure every medical professional interacting with patients is the best they can possibly be.
QUFW’s unwavering philosophy
At the heart of QUFW lies a foundational belief that Dr Cincotta absorbed early in his career: pregnancy ultrasounds should be managed, or at the very least reported on, by specialists who have their roots in obstetrics and gynaecology.
This isn’t a personal preference; it originates from a conviction that obstetric and gynaecological professionals offer the highest quality reporting. Their hands-on experience with pregnancies makes them uniquely positioned to understand and address issues more effectively than general radiologists. This ethos isn’t about professional exclusivity–it’s about delivering the best possible care to every woman who steps through their doors.
“We’re really trying to provide the very, very best quality service for the women,” Dr. Rob explains.
QUFW’s story spans nearly two decades, a remarkable achievement in a field that constantly evolves. Reflecting on these 18 years, Dr Cincotta beams with pride, not just for surviving the industry’s challenges but for thriving amid them.
A pivotal moment came about five years ago when the clinic underwent significant changes, setting the foundation for rapid growth. But for Dr Cincotta, expansion isn’t just about numbers. It’s about widening QUFW’s reach and ensuring its services touch as many lives as possible.
“We’ve been going for 18 years and we’re very, very proud of that. About five years ago we started to make a lot of changes because we wanted to strengthen ourselves, and we’ve grown quite rapidly in that period of time.”
“And we’re very, very proud of that, and happy that it’s gone this well.”
However, this expansion comes with its own set of challenges, mostly training and sourcing the right people. Yet, drawing from their success in the last half-decade, Dr Cincotta remains optimistic.
“We’re quite confident,” he asserts, “that with the success we’ve had, particularly over the last five years or so, that we can keep it going.”
Recharging outside of work
Behind the doctor is a man who enjoys the simple pleasures of family life. Outside of his professional sphere, Dr Cincotta has a penchant for films which he shares with his family, often finding solace in the cinematic experience, particularly time travel films.
Were he given a chance, he’d embrace the opportunity to be young again. Yet, if there was one nugget of wisdom he’d offer his younger self, it would be to “enjoy myself more” and “stress less.” A simple yet profound piece of advice that echoes his mantra: “It will be okay.”
He’s also an avid golfer, albeit self-proclaimed ‘bad’. With a chuckle, he admits to “hacking up a golf course” during golf trips with his son.
In this interview, Dr Cincotta not only offers a glimpse into the world of maternal-fetal medicine but also showcases the human side of a medical professional. His dedication, love for the profession, and belief in mentorship serve as an inspiration for both existing and upcoming medical practitioners.
Reflecting on his journey
Reflecting on his career that began in 1988, Dr Cincotta humorously notes the joy (and sign of time passing) in delivering babies for those he once delivered. His legacy is evident not only in the improved clinical outcomes for countless mothers and babies but also in the systems and services he has helped establish.
When prompted to explore any potential regrets or things he might have done differently, Dr Cincotta ’s response is very clear. With a chuckle and a sense of nostalgia, the doctor’s love for his profession shines through.
“Oh God, I’d just love to be able to do it all again,” he declares.
Through Dr. Cincotta’s insights, it’s easier to understand why QUFW has its reputation for industry-leading patient care. It’s more than just machines and medical practices; it’s a blend of expertise, dedication, and a genuine commitment to offering unparalleled care.
In the end, as he so aptly puts it, “that’s what it’s all about.”
–
September 2023
Content Disclaimer
The information provided on this website is for educational and informational purposes only. It is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment and before undertaking a new healthcare regimen.
The content on this website is not intended to be a comprehensive source of information on any particular topic and should not be relied upon as such. The authors and publishers of this website are not liable for any damages or injury resulting from the use or misuse of the information provided on this website.
As part of our commitment to providing exemplary care in women’s ultrasound in the Southport area, we have made some significant changes to our Southport clinics. These changes will affect our patients and our referring doctors.
These important changes are as follows:
1. QUFW’s Southport clinic is now located at a new physical address.
From Monday 3 July 2023, QUFW’s Southport location, at Suite 2401, Level 4, Southport Central Tower 2, 5 Lawson Street, Southport, moved to Level 4, 7 Short St, Southport. The Lawson Street clinic closed at 5pm on Friday 30 June 2023, and is no longer accepting patients at this location.
2. Swell Women’s Ultrasound is now located at a new physical address.
As you may know, on Tuesday 18 April 2023, Swell Women’s Ultrasound was acquired by QUFW. From Monday 3 July 2023, the team and facilities at Swell Women’s Ultrasound moved to Level 4, 7 Short St, Southport. The clinic at 134 Queen Street Southport closed at 5pm on Friday 30 June 2023, and is no longer accept patients at this location.
3. Swell Women’s Ultrasound’s name has changed to QUFW.
From Monday 3 July 2023, Swell Women’s Ultrasound’s name changed to QUFW.The friendly and experienced team at Swell Women’s Ultrasound are now QUFW team members. Any current patients of Swell Women’s Ultrasound will be welcomed as patients under the QUFW banner. There will be no interruptions to any current patients of Swell Women’s Ultrasound.
QUFW’s brand new location at Level 4, 7 Short St Southport features:
A purpose-built facility featuring a bright, warm and welcoming patient waiting area
4 ultrasound scanning rooms
Advanced reporting and analysis technology
NIPT collection facilities
Metered parking – 4 hour metered parking is available on Short Street or additional car parking available in the Gold Coast City Council Carey Car Park and Australia Fair Shopping Centre.
Our valued referring doctors will be provided with updated referral forms over the coming weeks.
We are excited about our new Southport home and, as always, we look forward to supporting you and your patients. We are here for you.
It was at this time in her career that Dr. Chua was influenced by two inspirational clinicians.
Dr. Chua is passionate about QUFW’s future, ensuring the clinic’s longevity by welcoming junior fellows without overwhelming them. She envisions a collaborative future, not just within her immediate team of sonographers but extending into the wider medical community, including GPs, to optimise care for women.
Fast forward two passionate decades, and Simone is now the Clinical Educator at QUFW. 
A good scan requires an attentive eye, adept hand-eye coordination, a strong connection with patients, an understanding of anatomy and physiology, and a deep knowledge of the technology at hand, Simone says.
Reflecting on her career, Simone is content with her choices. She wouldn’t change a thing. 
Thanks to Dr Cincotta’s efforts, laser treatment for twin-to-twin transfusion was introduced in Australia. This procedure involves using a device in the uterus to ablate the blood vessels connecting the twins. With this innovative technique, the outcomes improved dramatically for such pregnancies.
Starting in Brisbane, QUFW has expanded its reach to several parts of Southeast Queensland, ensuring that women receive high-quality ultrasound services.
At the heart of QUFW lies a foundational belief that Dr Cincotta absorbed early in his career: pregnancy ultrasounds should be managed, or at the very least reported on, by specialists who have their roots in obstetrics and gynaecology. 
Behind the doctor is a man who enjoys the simple pleasures of family life. Outside of his professional sphere, Dr Cincotta has a penchant for films which he shares with his family, often finding solace in the cinematic experience, particularly time travel films.
