ArticleAJOG global reports2023
Management of unexpected placenta accreta spectrum cases in resource-poor settings.
Article in AJOG global reports, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 24 citations in OpenAlex.
- The utility of serum markers in the conservative management of placenta accreta spectrum (PAS) by leaving the placenta in situ in women with high-grade PAS.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Article
- Uterus-preserving surgery for placenta accreta spectrum: An expert, illustrated review of techniques and its outcomes.Acta obstetricia et gynecologica Scandinavica · 2026Review
- Placenta Praevia and Placenta Accreta Spectrum: Diagnosis and Management: Green-Top Guideline No. 27a.BJOG : an international journal of obstetrics and gynaecology · 2026Article
- Placenta Accreta Spectrum: A Narrative Review of Clinical Management, Contemporary Innovations, And Global Challenges.International journal of medical science and dental health · 2026Article
- Strategies for streamlining uterine topographic classification in placenta accreta spectrum.AJOG global reports · 2026Article
- Telemedicine-assisted conservative management of placenta accreta spectrum: a case series from a tertiary center in Lithuania.BMC pregnancy and childbirth · 2026Article
- The critical role of diagnostic accuracy in differentiating uterine dehiscence and placenta accreta spectrum to enhance neonatal outcomes in complex cesarean sections.BMC pregnancy and childbirth · 2025Article
- Algorithm for timing of delivery in placenta accreta spectrum: role of cervical length and number of antepartum bleeding.BMC pregnancy and childbirth · 2025Article
- The Evolution of Management Strategies for Placenta Accreta Spectrum.Maternal-fetal medicine (Wolters Kluwer Health, Inc.) · 2024Article
- Telerehabilitation in Colombia: A Country Report and Qualitative Analysis During the Covid-19 Pandemic - Perceptions of Healthcare Providers and Patients.International journal of telerehabilitation · 2024Article
- Telemedicine Challenges in Latin-America: Outcomes from Telerehabilitation Services During the COVID-19 Pandemic in Cali, Colombia-A Retrospective Cohort Study.Advances in rehabilitation science and practiceArticle
Corrections and comments
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Authors and funding
5 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOn a global scale, cases of placenta accreta spectrum are often just identified during cesarean delivery because they are missed during antenatal care screening. Routine operating teams not trained in the management of placenta accreta spectrum are faced with difficult surgical situations and have to make decisions that may define the clinical outcomes. Although there are general recommendations for the intraoperative management of placenta accreta spectrum, no studies have described the clinical reality of unexpected placenta accreta spectrum cases in resource-poor settings.
objectiveThis study aimed to describe the maternal outcomes of previously undiagnosed placenta accreta spectrum managed in resource-poor settings in Colombia and Indonesia. STUDY
designThis was a retrospective case series of women with histologically confirmed placenta accreta spectrum treated in 2 placenta accreta spectrum centers after referral from remote resource-poor hospitals. Clinical outcomes were analyzed according to the initial type of management: (1) no cesarean delivery; (2) placenta left in situ after cesarean delivery; (3) partial removal of the placenta after cesarean delivery; and (4) post-cesarean hysterectomy. In addition, we evaluated the use of telemedicine by comparing the outcomes of women in hospitals that used the support of the placenta accreta spectrum center during the initial surgery.
resultsA total of 29 women who were initially managed in Colombia (n=2) and Indonesia (n=27) were included. The lowest volume of blood loss and the lowest frequency of complications were in women who underwent deferred cesarean delivery (n=5; 17.2%) and in those who had a delayed placental delivery (n=5; 20.7%). Five maternal deaths (14%) occurred in the group that did not receive telehelp, and 4 women died of irreversible shock because of uncontrolled bleeding.
conclusionPreviously undiagnosed placenta accreta spectrum in resource-poor hospitals was associated with a high risk of maternal mortality. Open-close abdominal surgery or leaving the placenta in situ seem to be the best choices for unexpected placenta accreta spectrum management in resource-poor settings. Telemedicine with a placenta accreta spectrum center may improve prognosis.
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