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- W4387260072 abstract "Placenta accreta spectrum (PAS) is characterised by uterine dehiscence and placental adherence resulting in significant morbidity. Greater degrees of myometrial disruption result in worse outcomes. Our primary aim was to assess the outcomes of an antenatal ultrasound-stratification protocol for the management of PAS. This study is a pre- and post-protocol implementation analysis in which patients were stratified by suspected depth of placental adherence on prenatal ultrasound. The algorithm included utilisation of a hybrid operating room, uterine artery embolisation and staffing by advanced pelvic surgeons in increta/percreta cases. Patients in the protocol group from 2019-2022 were compared to a 4-year (2015-2018) pre-implementation. Patient demographics and clinically relevant outcomes were obtained from electronic medical records. During the study period, a total of 93 PAS patients were managed by our team. 17 of 46 (37%) patients in the preimplementation cohort (37%) were suspected increta/percreta. During the postimplementation period, 24 of 53 (45%) cases were suspected increta/percreta. In cases of placenta accreta, no significant differences were noted in blood loss, transfusion rates or operative time (p > 0.05). In cases of suspected increta/percreta, our protocol was associated with lower blood loss (2500 vs 1500mL, p = 0.008), lower blood transfusion rates (88 vs 54%, p = 0.03) and longer operative time (261 vs 370 min, p = 0.009). Final pathology confirmed increta/percreta suspicion in 23/24 cases (96%). A stratification protocol for the management of PAS cases by ultrasound degree of pathology is feasible and results in better outcomes for patients with complex placental conditions. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article." @default.
- W4387260072 created "2023-10-03" @default.
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- W4387260072 date "2023-10-01" @default.
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- W4387260072 title "OP08.05: Implementation and outcomes of an antenatal ultrasound stratification protocol for the operative management of placenta accreta spectrum" @default.
- W4387260072 doi "https://doi.org/10.1002/uog.26514" @default.
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