Multidisciplinary Teams in the Management of Placenta Accreta Spectrum Disorders
Purpose of Review
The three-fold purpose of this review is to summarize recent evidence supporting the use of a multidisciplinary team (MDT) approach in patients with placenta accreta spectrum (PAS), to describe essential members and processes of the PAS MDT, and to highlight necessary resources for both planned and unexpected cases of PAS.
Maternal outcomes in women with PAS are improved when an antenatal diagnosis occurs and referral is made to centers with MDT specialization and experience in treating PAS. New guidelines unequivocally recommend referral to higher-volume, experienced PAS centers of excellence.
The diagnosis and treatment of patients with PAS are complex, resource-intensive, and pose high risk of maternal morbidity and mortality. Recent evidence suggests that stable, experienced MDTs focused on continuous systems improvement at high-volume tertiary care centers are superior to standard obstetric management for patients with PAS. Referral to a center of excellence is indicated when PAS is suspected.
KeywordsCesarean hysterectomy Multidisciplinary team Centers of excellence Patient safety Levels of maternal care Transfusion Obstetric anesthesiology
Compliance with Ethics Guidelines
Conflict of Interest
Brett D. Einerson and Robert M. Silver declare no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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