Is There a Place for Family-centered Cesarean Delivery during Placenta Accreta Spectrum Treatment?

Abstract

Objective Placenta accreta spectrum (PAS) is a cause of massive obstetric hemorrhage and maternal mortality. The application of family-centered delivery techniques (FCDTs) during surgery to treat this disease is infrequent. We evaluate the implementation of FCDTs during PAS surgeries. Methods This was a prospective, descriptive study that included PAS patients undergoing surgical management over a 12-month period. The patients were divided according to whether FCDTs were applied (group 1) or not (group 2), and the clinical outcomes were measured. In addition, hospital anesthesiologists were surveyed to evaluate their opinions regarding the implementation of FCDTs during the surgical management of PAS. Results Thirteen patients with PAS were included. The implementation of FCDTs during birth was possible in 53.8% of the patients. The presence of a companion during surgery and skin-to-skin contact did not hinder interdisciplinary management in any case. Conclusion Implementation of FCDTs during PAS care is possible in selected patients at centers with experience in managing this disease.

Family-centered Cesarean Section for Placenta Accreta Spectrum: Questions and an Addition

“…However, in PAS, this is not an option and may cause a marked stress. 4,5 Nieto-Calvache et al 1 did not show that FCS at PAS-CS reduces the occurrence of posttraumatic stress disorder. They should not be blamed for this because the purpose of their study was to show that FCS can be performed even at PAS-CS.…”

“…Nieto-Calvache et al 1 showed that family-centered cesarean section (FCS) was possible in 53.8% of patients undergoing cesarean section (CS) for placenta accreta spectrum (PAS). Main concepts of FCS are: earlier skin-to-skin contact and cesarean delivery in a relaxed atmosphere.…”

“…The first question regards the meaning of "companion." Nieto-Calvache et al 1 state the importance of the presence of a "companion" in the surgical theater. Companion has various meanings: partner (husband), pregnant woman's mother (or a relative), doula, or other person.…”

“…I wish to know how women after PAS-CS are followed in Nieto-Calvache et al's institute. 1 In many Japanese institutes, obstetric nurses or midwives psychologically support mothers during CS: I believe that this is also performed in many other countries. In our institute, we allocate a nurse or midwife to a high-risk pregnant woman (such as a woman with PAS) on an individual basis.…”