TY - JOUR
T1 - Geographic variation in management of patients with placenta accreta spectrum
T2 - An international survey of experts (GPASS)
AU - Brown, Alec D.
AU - Hart, Jessica M.
AU - Modest, Anna M.
AU - Hess, Philip E.
AU - Abbas, Ahmed M.
AU - Nieto-Calvache, Albaro J.
AU - Bhide, Amarnath
AU - Lim, Boon
AU - Dunjin, Chen
AU - Palacios-Jaraquemada, José
AU - Sentilhes, Loïc
AU - Soma-Pillay, Priya
AU - Aryananda, Rozi A.
AU - Hantoushzadeh, Sedigheh
AU - Wang, Shan
AU - Shamshirsaz, Alireza A.
AU - Shainker, Scott A.
N1 - Publisher Copyright:
© 2021 International Federation of Gynecology and Obstetrics.
PY - 2022/7
Y1 - 2022/7
N2 - 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.
AB - 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.
KW - cesarean hysterectomy
KW - geographic variation in care
KW - placenta accreta spectrum
KW - prenatal diagnosis
UR - https://www.scopus.com/pages/publications/85117954830
U2 - 10.1002/ijgo.13960
DO - 10.1002/ijgo.13960
M3 - Article
SN - 0020-7292
VL - 158
SP - 129
EP - 136
JO - International Journal of Gynecology and Obstetrics
JF - International Journal of Gynecology and Obstetrics
IS - 1
ER -