TY - JOUR
T1 - Management of placenta accreta spectrum in low- and middle-income countries
AU - Nieto-Calvache, Albaro José
AU - Palacios-Jaraquemada, Jose M.
AU - Hussein, Ahmed M.
AU - Jauniaux, Eric
AU - Milani Coutinho, Conrado
AU - Rijken, Marcus
N1 - Publisher Copyright: © 2024 Elsevier Ltd
PY - 2024/6/1
Y1 - 2024/6/1
N2 - Placenta accreta spectrum (PAS) can be associated massive intra- and post-operative hemorrhage which when not controlled can lead to maternal death. Important advances have occurred in understanding the pathophysiology and therapeutic options for this condition. The prevalence of PAS at birth is direct association with the cesarean delivery (CD) rate in the corresponding population and is increasing worldwide. Limited health infrastructure in low- and middle-income countries increases the morbidity and mortality of patients with PAS at birth. In many cases, obstetricians working in limited resources settings cannot follow some of the international guideline's recommendations and have to opt for low-cost management procedures. In this review, we describe the particularities of managing PAS care in low- and middle-income countries from of prenatal evaluation of patients at risk of PAS at birth, therapeutic options, and inter-institutional collaboration. We also propose a management protocol based on training of the local obstetric teams rather than on sophisticated technological resources that are almost never available in low-resource scenarios.
AB - Placenta accreta spectrum (PAS) can be associated massive intra- and post-operative hemorrhage which when not controlled can lead to maternal death. Important advances have occurred in understanding the pathophysiology and therapeutic options for this condition. The prevalence of PAS at birth is direct association with the cesarean delivery (CD) rate in the corresponding population and is increasing worldwide. Limited health infrastructure in low- and middle-income countries increases the morbidity and mortality of patients with PAS at birth. In many cases, obstetricians working in limited resources settings cannot follow some of the international guideline's recommendations and have to opt for low-cost management procedures. In this review, we describe the particularities of managing PAS care in low- and middle-income countries from of prenatal evaluation of patients at risk of PAS at birth, therapeutic options, and inter-institutional collaboration. We also propose a management protocol based on training of the local obstetric teams rather than on sophisticated technological resources that are almost never available in low-resource scenarios.
KW - Low- and middle-income countries
KW - Placenta accreta
KW - Resource-limited settings
KW - Telehealth
KW - Telemedicine
UR - http://www.scopus.com/inward/record.url?scp=85187020501&partnerID=8YFLogxK
U2 - 10.1016/j.bpobgyn.2024.102475
DO - 10.1016/j.bpobgyn.2024.102475
M3 - Review article
C2 - 38452606
SN - 1521-6934
VL - 94
JO - Best practice & research. Clinical obstetrics & gynaecology
JF - Best practice & research. Clinical obstetrics & gynaecology
M1 - 102475
ER -