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

2017; Elsevier BV; Volume: 140; Issue: 3 Linguagem: Inglês

10.1002/ijgo.12391

1879-3479

M. Cal, Diogo Ayres‐de‐Campos, Eric Jauniaux,

Maternal and Perinatal Health Interventions

Abstract 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.