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Current Obstetrics and Gynecology Reports

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27.06.2019 | Aberrant Placentation: Contemporary Management of Placenta Accreta (E Jauniaux, Section Editor)

Managing Placenta Accreta Spectrum Disorders (PAS) in Middle/Low-Resource Settings

verfasst von: Ahmed M. Hussein, Ahmed Kamel, Rasha A. Elbarmelgy, Mohamed M. Thabet, Rana M. Elbarmelgy

Erschienen in: Current Obstetrics and Gynecology Reports | Ausgabe 3/2019

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Abstract

Purpose of Review

The purpose of this review is to describe the technical issues associated with managing the placenta accreta spectrum (PAS) disorders in a low-resource setting and to provide insight on how to improve the outcome under these conditions.

Recent Findings

The available literature recommends managing PAS in a specialized center with a multidisciplinary team (MDT), but there are no standardized management strategies that would help reduce maternal and neonatal morbidity and mortality in a low-resource setting. The increase in the incidence of PAS has been mainly in middle/low-income countries due to high birth and cesarean delivery rates, and thus, there is a need to develop affordable management strategies. Additional techniques for the diagnosis such as MRI and surgical techniques such as balloon occlusion catheters, and other interventional radiology techniques may contribute to reducing maternal morbidities and mortalities in high-income countries but are often not available in a middle/low-resource setting. Similarly, current conservative management techniques can be associated with high complication rates and perinatal costs and thus questionable in a low-resource setting. Within this context, management strategies need to be adapted to local need to reduce both maternal and neonatal complications and costs.

Summary

New management strategies that can help reduce complication rates and costs of managing PAS in different middle/low-resource settings should be standardized using a cost-benefit analysis. Data analysis should take into account local expertise and should be tailored for local need and access to blood transfusion and adult and neonatal intensive care.

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Titel: Managing Placenta Accreta Spectrum Disorders (PAS) in Middle/Low-Resource Settings
verfasst von: Ahmed M. Hussein
Ahmed Kamel
Rasha A. Elbarmelgy
Mohamed M. Thabet
Rana M. Elbarmelgy
Publikationsdatum: 27.06.2019
Verlag: Springer US
Erschienen in: Current Obstetrics and Gynecology Reports / Ausgabe 3/2019
Elektronische ISSN: 2161-3303
DOI: https://doi.org/10.1007/s13669-019-00263-y

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Managing Placenta Accreta Spectrum Disorders (PAS) in Middle/Low-Resource Settings