Nieto-Calvache, Albaro Jose;
Jauniaux, Eric;
Fox, Karin A;
Maya, Juliana;
Stefanovic, Vedran;
Weizsäcker, Katharina;
Van Beekhuizen, Heleen;
... International Society for PAS (IS-PAS) LMIC Working Group; + view all
(2024)
Are international guideline recommendations for the management of placenta accreta spectrum applicable in low- and middle-income countries?
International Journal of Gynecology & Obstetrics
10.1002/ijgo.15473.
(In press).
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Abstract
Objective: The aim of this study was to explore how obstetricians-gynecologists in low- and middle-income countries (LMICs) can apply current international clinical practice guidelines (CPGs) for the management of placenta accreta spectrum (PAS) in limited resource settings. // Methods: This was an observational, survey-based study. Clinicians with expertise in managing patients with PAS in LMICs were contacted for their evaluation of the recommendations included in four PAS clinical practice guidelines. // Results: Out of the 158 clinicians contacted, we obtained responses from 65 (41.1%), representing 27 middle income countries (MICs). The results of this survey suggest that the care of PAS patients in middle income countries is very different from what is recommended by international CPGs. Participants in the survey identified that their practice was limited by insufficient availability of hospital infrastructure, low resources of local health systems and lack of trained multidisciplinary teams (MDTs) and this did not enable them to follow CPG recommendations. Two-thirds of the participants surveyed describe the absence of centers of excellence in their country. In over half of the referral hospitals with expertise in managing PAS, there are no MDTs. One-third of patients with intraoperative findings of PAS are managed by the team initially performing the surgery (without additional assistance). // Conclusion: The care of patients with PAS in middle income countries frequently deviates from established CPG recommendations largely due to limitations in local resources and infrastructure. New practical guidelines and training programs designed for low resource settings are needed.
| Type: | Article |
|---|---|
| Title: | Are international guideline recommendations for the management of placenta accreta spectrum applicable in low- and middle-income countries? |
| Location: | United States |
| DOI: | 10.1002/ijgo.15473 |
| Publisher version: | http://dx.doi.org/10.1002/ijgo.15473 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Clinical practice guidelines; low middle income countries; placenta accreta spectrum |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health > Reproductive Health |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10190070 |
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