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



Brown AD¹ ; Hart JM^{1, 2} ; Modest AM^{1, 2} ; Hess PE^{1, 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
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.