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Geographic Variation in Management of Patients With Placenta Accreta Spectrum: An International Survey of Experts (Gpass) Publisher Pubmed



Brown AD1 ; Hart JM1, 2 ; Modest AM1, 2 ; Hess PE1, 2, 3 ; Abbas AM4 ; Nietocalvache AJ5 ; Bhide A6 ; Lim B7 ; Dunjin C8 ; Palaciosjaraquemada J9 ; Sentilhes L10 ; Somapillay P11 ; Aryananda RA12 ; Hantoushzadeh S13 Show All Authors
Authors
  1. Brown AD1
  2. Hart JM1, 2
  3. Modest AM1, 2
  4. Hess PE1, 2, 3
  5. Abbas AM4
  6. Nietocalvache AJ5
  7. Bhide A6
  8. Lim B7
  9. Dunjin C8
  10. Palaciosjaraquemada J9
  11. Sentilhes L10
  12. Somapillay P11
  13. Aryananda RA12
  14. Hantoushzadeh S13
  15. Wang S14
  16. Shamshirsaz AA15
  17. Shainker SA1, 2
Show Affiliations
Authors Affiliations
  1. 1. Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, United States
  2. 2. Harvard Medical School, Boston, MA, United States
  3. 3. Department of Anesthesia, Critical Care & Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States
  4. 4. Department of Obstetrics and Gynecology, Faculty of Medicine, Assiut University, Assiut, Egypt
  5. 5. Fundacion Valle Del Lili, Cali, Colombia
  6. 6. St George's University of London, London, United Kingdom
  7. 7. Canberra Hospital, Australian National University, Canberra, Australia
  8. 8. Guangzhou Medical University, Guangzhou, China
  9. 9. Universidad de Buenos Aires, Buenos Aires, Argentina
  10. 10. Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
  11. 11. University of Pretoria, Pretoria, South Africa
  12. 12. Universitas Airlangga, Surabaya, Indonesia
  13. 13. Tehran University of Medical Sciences, Tehran, Iran
  14. 14. Shandong First Medical University, Tai'an, China
  15. 15. Baylor College of Medicine, Houston, TX, United States

Source: International Journal of Gynecology and Obstetrics Published:2022


Abstract

Objective: To describe global geographic variations in the diagnosis and management of placenta accreta spectrum (PAS). Methods: An international cross-sectional study was conducted among PAS experts practicing at medical institutions in member states of the United Nations. Survey questions focused on diagnostic evaluation and management strategies for PAS. Results: A total of 134 centers participated. Participating centers represented each of the United Nations' designated regions. Of those, 118 (88%) reported practicing in a medium-volume or high-volume center. First-trimester PAS screen was reported in 35 (26.1%) centers. Respondents consistently implement guideline-supported care practices, including utilization of ultrasound as the primary diagnostic modality (134, 100%) and implementation of multidisciplinary care teams (115, 85.8%). Less than 10% of respondents reported routinely managing PAS without hysterectomy; these centers were predominantly located in Europe and Africa. Antepartum management and availability of mental health support for PAS patients varied widely. Conclusion: Worldwide, there is a strong adherence to PAS care guidelines; however, regional variations do exist. Comparing variations in care to outcomes will provide insight into the clinically significant practice variability. © 2021 International Federation of Gynecology and Obstetrics.
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