Guidelines on Placenta Accreta Spectrum Disorders

What are the levels of agreement and gaps in guidelines for placenta accreta spectrum disorders across different income settings?This systematic review of 14 guidelines from national and international societies found high agreement on specialized expertise needed and antenatal management but poor consensus on management, including cesarean hysterectomy and conservative surgical techniques. Many topics with insufficient evidence were identified, especially for postnatal care, but only 1 guideline addressed specific needs for low- and middle-income countries.There are substantial discrepancies and evidence gaps in placenta accreta spectrum guidelines worldwide, suggesting that increased research and guideline standardization are needed to improve PAS management globally.

Corresponding Author: Alireza A. Shamshirsaz, MD, Fetal Care and Surgery Center, Division of Fetal Medicine and Surgery, Boston Children’s Hospital, Harvard Medical School, 300 Longwood Ave, Boston, MA 02115 (alireza.shamshirsaz@childrens.harvard.edu).

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