Management of pregnancies complicated by placenta accreta spectrum utilizing a multidisciplinary care team in a rural state

Sandlin, Adam T.; Magann, Everett F.; Whittington, Julie R; Schneider, Allison M; Ramseyer, Abigail M; Hughes, Dawn S.; Ounpraseuth, Songthip

doi:10.1080/14767058.2021.1903425

Cited by 14 publications

(19 citation statements)

References 11 publications

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“…Telemedicine is used to improve US 5 and MRI diagnosis, 11 facilitate the referral process, 5,17 solve specific doubts related to the management of PAS, 18 and improve the planning and execution of PAS surgeries 11,18 …”

Section: Discussionmentioning

confidence: 99%

“…Information and communication technologies (ICTs) have revolutionized medical education and practice 3 . The flow of high‐quality information and fluid contact among medical groups from different locations has shown its usefulness, particularly for rare conditions 4–6 …”

Section: Introductionmentioning

confidence: 99%

“…3 The flow of high-quality information and fluid contact among medical groups from different locations has shown its usefulness, particularly for rare conditions. [4][5][6] Few hospitals treat many PAS patients each year, and fewer have trained interdisciplinary groups. 7 Furthermore, an intrasurgical PAS diagnosis is possible in one of three patients 8 ; thus, groups without extensive training will certainly face PAS.…”

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confidence: 99%

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Telemedicine facilitates surgical training in placenta accreta spectrum

Nieto-Calvache

Palacios‐Jaraquemada

Aguilera

et al. 2021

Intl J Gynecology & Obste

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Placenta accreta spectrum (PAS) quality care demands abundant health resources, including trained surgical teams. Although surgeon training is related to better clinical results 1 and improper surgical techniques are associated with death due to PAS, 2 training in the management of this disease is challenging because no specific educational programs exist and the flow of patients is variable, even at specialized centers.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Telemedicine facilitates surgical training in placenta accreta spectrum

Nieto-Calvache

Palacios‐Jaraquemada

Aguilera

et al. 2021

Intl J Gynecology & Obste

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“…In the absence of formal face‐to‐face training programs for PAS, and taking into account the long road that a group must travel to be considered an expert, the priorities to improve the management of PAS identified by Latin American hospitals make it clear that it is necessary to share information between centers with different degrees of expertise 4 and to facilitate access to education around surgical techniques by training groups.…”

mentioning

confidence: 99%

“…The establishment of virtual academic and educational networks, as well as “tele‐help” and telepresence during ultrasound or surgical procedures, are strategies that can facilitate the timely referral of patients with risk factors, doubtful prenatal images, or a prenatal diagnosis of PAS 4 . Additionally, the information flow through virtual channels between groups interested in PAS can become a training and follow‐up option for sonographers and surgeons interested in accelerating their learning curve.…”

mentioning

confidence: 99%

Priorities for improving care in the placenta accreta spectrum

Nieto-Calvache

Treviño²,

Torre

et al. 2021

Intl J Gynecology & Obste

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Successful multidisciplinary team management of placenta accreta spectrum disorder: A referral center model in a middle‐income country

Muadtongon,

Rattanaburi,

Ajimakul

et al. 2024

Intl J Gynecology & Obste

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ObjectiveThe aim of the study was to evaluate the outcomes of placenta accreta spectrum (PAS) disorder managed by a multidisciplinary care team (MCT) compared with a conventional care team (CCT) in a PAS referral center in Thailand.MethodsThis retrospective single‐center cohort study analyzed PAS management outcomes in the PSU PAS Center between January 2010 and December 2022. The incidence of hemorrhage ≥3500 mL and the composite maternal and neonatal outcomes of PAS were compared before and after the introduction of an MCT in 2016.ResultsOf 227 PAS cases, 219 (96.5%) had pathological confirmation. There were 52 (22.9%) cases of placenta accreta, 119 (52.4%) cases of placenta increta, and 56 (24.7%) cases of placenta percreta. The incidence of estimated blood loss (EBL) ≥3500 mL decreased from 61.8% to 34.3% (P < 0.001) after the establishment of the MCT. The median EBL decreased from 4000 (IQR: 2600,7250) mL to 2250 (1300, 4750) mL (P < 0.001). EBL reduction was statistically significant in the accreta and increta groups (P < 0.001). Red blood cell transfusions decreased from five (3, 9) to two (1, 6) units (P < 0.001) per patient. The length of maternal hospital stays and ICU admissions were statistically shorter when PAS was managed by an MCT (P < 0.001). The length of newborn hospital and ICU stays decreased significantly (P < 0.001).ConclusionThe incidence of massive postpartum hemorrhage and a composite of maternal and neonatal morbidities in pregnant women with PAS disorder improved significantly after the establishment of an MCT to manage PAS in a middle‐income country setting.

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Management of pregnancies complicated by placenta accreta spectrum utilizing a multidisciplinary care team in a rural state

Cited by 14 publications

References 11 publications

Telemedicine facilitates surgical training in placenta accreta spectrum

Telemedicine facilitates surgical training in placenta accreta spectrum

Priorities for improving care in the placenta accreta spectrum

Successful multidisciplinary team management of placenta accreta spectrum disorder: A referral center model in a middle‐income country

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