Akademik Veri Yönetim Sistemi
Istanbul Tip Fakultesi Dergisi, cilt.87, sa.1, ss.43-53, 2024 (ESCI)
Objective: To determine the differences and consensus points in managing patients with placenta accreta spectrum (PAS) disorder in a nationwide survey. Material and Method: Forty-seven items were asked via an online survey. Seventy-seven percent responded to the survey (37/48). Consensus/strong consensus was predefined as 75%-89% (28-33/37)/>90% (≥34/37) of panelists agreeing on an answer. Result: In a few areas, consensus or strong consensus was achieved. These are the absence of interventional radiology (89.2%) and cell-saver in the institution (94.6%), a rare selection of magnetic resonance (83.8%), and frequent use of transvaginal so-nography (94.6%) as an adjuvant diagnostic tool. Penetrative sexual intercourse is prohibited (78.4%); perineal shaving (81.1%) and rectal enema (94.6%) are not used; general anesthesia (75.7%) is the preferred technique; hypothermia control (97.3%) is not omitted; and administration of oxytocin (75.7%) is similar to routine cesarean section; vascular injuries are managed by vascular surgeons (78.4%); gynecologic oncologists are not a regular part of the surgical team (86.5%); routine insertion of a central venous cannula (78.4%) is not considered and placement of an abdominal drain (89.2%) is usually performed. Surgery is often performed through a median abdominal incision (83.8%), and a total hysterectomy (81.1%) is chosen. Routine hypogastric artery ligation (91.9%) is not performed. In the postoperative period, the patients are allowed to have early mobilization (91.9%) and oral intake (83.8%). They are habitually discharged on the 3rd-4th postoperative day (75.7%). Psychiatric needs are often neglected (94.6%). Conclusion: These consensus points could help obstetricians manage this complicated condition. These results also demonstrate the need for evidence-based data for implementing proper treatment strategies for PAS disorder. Future research is sought for these points.