Management of placenta accreta: a survey of Maternal-Fetal Medicine practitioners
Source: Journal of Maternal-Fetal and Neonatal Medicine, Volume 25, Number 6, June 2012 , pp. 756-760(5)
Publisher: Informa Healthcare
Abstract:Objective: To describe the management strategies for placenta accreta used by Maternal-Fetal Medicine practitioners. Methods: We conducted a 36-question online survey of members of the Society for Maternal-Fetal Medicine regarding management of placenta accreta, and tabulated the results. Results: We had 508 respondents. Most respondents have been in practice for >20 years (30%), at a university-affiliated institution (58.1%). In the previous 2 years, 44.6% of respondents operated on 1–3 cases of placenta accreta, with 3% having operated on greater than 10 cases. Magnetic resonance imaging (MRI) is used as a diagnostic adjunct when the suspicion for accreta is both low (43.1%) and high (68%). In asymptomatic patients with high suspicion for accreta, 15.4% of practitioners hospitalize patients antenatally, 34.5% administer corticosteroids, and 46.8% perform amniocentesis for fetal lung maturity prior to delivery, which they schedule most commonly at 36 weeks (48.4%). Equipment requested prior to delivery includes intravascular balloon catheters (35%) and ureteral stents or catheters (26.2%). With high suspicion for accreta intraoperatively, the majority proceed with hysterectomy, but 14.9% report conservative management. Conclusion: Survey respondents employ diverse approaches in the management of patients with placenta accreta. Further study may lead to consensus strategies to improve outcome in this high-risk obstetric condition.
Document Type: Research Article
Affiliations: 1: 1Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of California, Irvine, Orange, CA, USA 2: 2MemorialCare Center for Women, Long Beach Memorial Medical Center, Long Beach, CA, USA
Publication date: June 2012