THE MANAGEMENT STRATEGIES IN THE PLACENTA ACCRETA SPECTRUM IN TERTIARY CENTERS IN TURKIYE
Küçük Resim Yok
Tarih
2024
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Istanbul Univ, Fac Medicine, Publ Off
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
Objective: To determine the differences and consensus points in managing patients with placenta accreta spectrum (PAS) disorder in a nationwide survey.Material and Method: Forty-seven items were asked via an online survey. Seventy-seven percent responded to the survey (37/48). Consensus/strong consensus was predefined as 75%-89% (28-33/37)/>90% (234/37) of panelists agreeing on an answer.Result: In a few areas, consensus or strong consensus was achieved. These are the absence of interventional radiology (89.2%) and cell-saver in the institution (94.6%), a rare selection of magnetic resonance (83.8%), and frequent use of transvaginal sonography (94.6%) as an adjuvant diagnostic tool. Penetrative sexual intercourse is prohibited (78.4%); perineal shaving (81.1%) and rectal enema (94.6%) are not used; general anesthesia (75.7%) is the preferred technique; hypothermia control (97.3%) is not omitted; and administration of oxytocin (75.7%) is similar to routine cesarean section; vascular injuries are managed by vascular surgeons (78.4%); gynecologic oncologists are not a regular part of the surgical team (86.5%); routine insertion of a central venous cannula (78.4%) is not considered and placement of an abdominal drain (89.2%) is usually performed. Surgery is often performed through a median abdominal incision (83.8%), and a total hysterectomy (81.1%) is chosen. Routine hypogastric artery ligation (91.9%) is not performed. In the postoperative period, the patients are allowed to have early mobilization (91.9%) and oral intake (83.8%). They are habitually discharged on the 3rd-4th postoperative day (75.7%). Psychiatric needs are often neglected (94.6%).Conclusion: These consensus points could help obstetricians manage this complicated condition. These results also demonstrate the need for evidence-based data for implementing proper treatment strategies for PAS disorder. Future research is sought for these points.
Açıklama
Anahtar Kelimeler
Perinatology, placenta accreta, postpartum hemorrhage, surveys and questionnaires
Kaynak
Journal of Istanbul Faculty of Medicine-Istanbul Tip Fakultesi Dergisi
WoS Q Değeri
N/A
Scopus Q Değeri
Q4
Cilt
87
Sayı
1
