Management of abnormal invasive placenta in a low- and medium-resource setting

Best Pract Res Clin Obstet Gynaecol. 2021 Apr:72:117-128. doi: 10.1016/j.bpobgyn.2020.08.004. Epub 2020 Aug 13.

Abstract

The purpose of this review is to describe the panorama of placenta accreta spectrum (PAS) disorder management in low- and middle-income countries, providing information that allows for the improvement of maternal and perinatal outcomes in the management of this pathology. This spectrum of disorders is associated with implications of high morbidity and mortality, both maternal and perinatal, which is why clinical practice guidelines based on management are produced in settings where there is a wide range of available resources. This situation often contrasts with what the reality is in low-resource countries. Prenatal diagnosis of placental accreta is essential to carry out adequate surgical planning in centres where multidisciplinary teams are in place, which improve results and reduce complications. These ideal scenarios should be developed in countries with more significant difficulties in the availability of human and technological resources, through teamwork in the different hospital centres and the adequate transfer of patients at higher risk to centres with the best interdisciplinary management skills.

Keywords: Low-income countries; Low-resource settings; Placenta accreta spectrum; Placenta increta; Placenta percreta.

Publication types

  • Review

MeSH terms

  • Female
  • Humans
  • Placenta
  • Placenta Accreta* / diagnostic imaging
  • Placenta Accreta* / therapy
  • Placenta Previa*
  • Pregnancy
  • Prenatal Diagnosis