Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, Boston, Massachusetts.
Am J Perinatol. 2024 May;41(S 01):e486-e493. doi: 10.1055/a-1905-5079. Epub 2022 Jul 20.
Placenta accreta spectrum (PAS) is an obstetric diagnosis that carries significant risks. However, little is known about patient perceptions of care. This study was conducted to describe the patient experience, reported outcomes, and assess geographical variation in PAS care in the United States.
Partnering with a PAS patient advocacy organization, we conducted an online survey of PAS patients. Perceptions of care and outcomes, and geographic variation were described.
We received 108 responses (69% response rate); 103 respondents delivered in the United States. Demographic characteristics were similar across each region. Most (67%) reported at least one prior cesarean delivery and 53% reported placenta previa in the PAS pregnancy. Over half (63%) reported an antenatal suspicion of PAS and 66% of those respondents reported changing their delivery hospital as a result of their antenatal diagnosis. Though not statistically significant, both showed variability across regions (both ≥0.60). Seventy-five percent of respondents with antenatal diagnosis reported their pregnancy was managed by a dedicated PAS care team, which did not differ by region ( = 0.80). A majority of respondents (75%) felt their PAS care team was prepared for their delivery; this too did not vary across regions ( = 0.97). Many respondents reported at least one physical (63%) or mental health (17%) adverse outcome as a result of their PAS pregnancy.
As reported by prior PAS patients, perception of care and outcomes are overall favorable. There are long-term physical and mental adverse consequences reported. Geographical variation is mixed, however, national guidelines are predominately followed.
· Patient perceptions of care and outcomes are overall positive and favorable.. · Long lasting physical and mental health consequence from PAS pregnancies are commonly seen.. · Multidisciplinary care is widely adopted for PAS pregnancies..
胎盘植入谱系（PAS）是一种具有重大风险的产科诊断。然而，人们对患者对护理的看法知之甚少。本研究旨在描述美国 PAS 患者的体验、报告结果，并评估 PAS 护理的地域差异。
与 PAS 患者倡导组织合作，我们对 PAS 患者进行了在线调查。描述了对护理的看法和结果，以及地域差异。
我们收到了 108 份回复（69%的回复率）；103 名受访者在美国分娩。每个地区的人口统计学特征相似。大多数（67%）报告至少有一次剖宫产史，53%报告 PAS 妊娠时胎盘前置。超过一半（63%）报告产前怀疑 PAS，其中 66%的受访者因产前诊断而改变了分娩医院。尽管没有统计学意义，但这两个指标在各个地区都存在差异（均≥0.60）。有产前诊断的 75%的受访者报告他们的妊娠由专门的 PAS 护理团队管理，这与地区无关（ = 0.80）。大多数受访者（75%）表示他们的 PAS 护理团队为分娩做好了准备；这在各个地区也没有差异（ = 0.97）。许多受访者报告说，由于 PAS 妊娠，他们至少经历了一次身体（63%）或心理健康（17%）不良后果。
正如之前的 PAS 患者所报告的，对护理和结果的看法总体上是积极的。报告称存在长期的身体和心理健康不良后果。然而，地域差异是混合的，但是，主要遵循国家指南。
·患者对护理和结果的看法总体上是积极和有利的。·PAS 妊娠后常见长期的身心健康后果。·多学科护理广泛应用于 PAS 妊娠。
