International survey of practices used in the diagnosis and management of placenta accreta spectrum disorders

Objective To identify geographic differences in diagnostic and treatment practices during the perinatal management of placenta accreta spectrum (PAS) disorders. Methods An online survey was conducted from May 1 to August 1, 2017. The 18‐item questionnaire was emailed to all members of the expert pan...

Full description

Saved in:
Bibliographic Details
Published in:International journal of gynecology and obstetrics 2018-03, Vol.140 (3), p.307-311
Main Authors: Cal, Margarida, Ayres‐de‐Campos, Diogo, Jauniaux, Eric
Format: Article
Language:English
Subjects:
Cesarean hysterectomy
Conservative management
Placenta accreta spectrum disorders
Placenta previa
Prenatal diagnosis
Surgical management
Ultrasound imaging
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Objective To identify geographic differences in diagnostic and treatment practices during the perinatal management of placenta accreta spectrum (PAS) disorders. Methods An online survey was conducted from May 1 to August 1, 2017. The 18‐item questionnaire was emailed to all members of the expert panel for the 2018 International Federation of Gynecology and Obstetrics consensus guidelines on PAS (n=34), as well as international experts who had contributed to the content of these guidelines (n=16). Results Questionnaires were returned by 36 of the 50 experts (72% response rate). Most respondents were from Europe (n=22; 61%) or Asia (n=9; 25%). Despite large disparity in the number of patients with PAS disorders managed surgically or conservatively (range from 0 to >1000) and the different techniques used by the respondents, the screening and diagnostic methods used were similar, with transvaginal imaging used by 31 (86%) experts, and both ultrasonography and magnetic resonance imaging used by 22 (61%). In all, 22 (61%) experts indicated a preference for radical surgery, with primary cesarean hysterectomy leaving the placenta in situ reported as the most frequent approach (n=20; 55%). Conclusion Wide variation found in global PAS practices indicated a need for standardized data and an evidence‐based approach to the diagnosis and management of PAS disorders. Wide variations existed in the diagnosis and management of placenta accreta spectrum disorders; however, most respondents favored cesarean hysterectomy with the placenta left in situ.
ISSN:0020-7292
1879-3479
DOI:10.1002/ijgo.12391