PDF(Pubmed)
Abstract：
BACKGROUND: Management options for placenta accreta spectrum disorder are multiple, without a clear picture of which one is superior. Management guidelines describe the use of a wide range of human and technological resources that are not always available in resource-limited settings.
OBJECTIVE: This consensus seeks agreement on general guidelines that facilitate the management of placenta accreta spectrum in low- and middle-income countries.
METHODS: Consensus was developed using the modified Delphi methodology, incorporating 3 successive rounds in which 6 dimensions of placenta accreta spectrum treatment were discussed: pathway for placenta accreta spectrum care, roles at different levels of care, organization of the interdisciplinary teams at the reference hospitals, training interdisciplinary teams, placenta accreta spectrum surgical treatment, and management of placenta accreta spectrum patients without prenatal diagnosis.
RESULTS: Consensus was achieved on all questions on placenta accreta spectrum management. Specific low- and middle-income countries problems were addressed, trying to establish guidelines for the construction of trained placenta accreta spectrum interdisciplinary teams, as well as the rational use of the different therapeutic options available in a limited resources setting. In addition, it is highlighted the need to facilitate contact between patients affected by this disease and the interdisciplinary groups, overcoming administrative barriers typical of some health systems.
CONCLUSIONS: We present a consensus on the treatment of placenta accreta spectrum in a low- and middle-income countries, based on local experts\' opinions. Construction of high-quality scientific evidence is essential in settings with limited resources.
OBJECTIVE: This consensus seeks agreement on general guidelines that facilitate the management of placenta accreta spectrum in low- and middle-income countries.
METHODS: Consensus was developed using the modified Delphi methodology, incorporating 3 successive rounds in which 6 dimensions of placenta accreta spectrum treatment were discussed: pathway for placenta accreta spectrum care, roles at different levels of care, organization of the interdisciplinary teams at the reference hospitals, training interdisciplinary teams, placenta accreta spectrum surgical treatment, and management of placenta accreta spectrum patients without prenatal diagnosis.
RESULTS: Consensus was achieved on all questions on placenta accreta spectrum management. Specific low- and middle-income countries problems were addressed, trying to establish guidelines for the construction of trained placenta accreta spectrum interdisciplinary teams, as well as the rational use of the different therapeutic options available in a limited resources setting. In addition, it is highlighted the need to facilitate contact between patients affected by this disease and the interdisciplinary groups, overcoming administrative barriers typical of some health systems.
CONCLUSIONS: We present a consensus on the treatment of placenta accreta spectrum in a low- and middle-income countries, based on local experts\' opinions. Construction of high-quality scientific evidence is essential in settings with limited resources.
摘要：
背景：胎盘植入谱系障碍的治疗方案有多种，没有一个清晰的图片是哪个更好。管理准则描述了广泛的人力和技术资源的使用，这些资源在资源有限的环境中并不总是可用的。
目的：本共识旨在就促进中低收入国家胎盘植入谱管理的一般指南达成一致。
方法：共识是使用改进的德尔菲方法开发的，纳入连续3轮，其中讨论了6个维度的胎盘植入频谱治疗：胎盘植入频谱治疗的途径，在不同层次的护理中的角色，在参考医院组织跨学科团队，培训跨学科团队，胎盘植入谱外科治疗,未进行产前诊断的胎盘植入谱患者的处理。
结果：在胎盘植入频谱管理的所有问题上达成共识。解决了低收入和中等收入国家的具体问题，试图建立训练有素的胎盘植入光谱跨学科团队的建设指南，以及在有限的资源环境中合理使用不同的治疗方案。此外,强调需要促进受这种疾病影响的患者与跨学科群体之间的接触，克服一些卫生系统典型的行政障碍。
结论：我们就中低收入国家胎盘植入谱的治疗达成共识，根据当地专家的意见。在资源有限的环境中，构建高质量的科学证据至关重要。
目的：本共识旨在就促进中低收入国家胎盘植入谱管理的一般指南达成一致。
方法：共识是使用改进的德尔菲方法开发的，纳入连续3轮，其中讨论了6个维度的胎盘植入频谱治疗：胎盘植入频谱治疗的途径，在不同层次的护理中的角色，在参考医院组织跨学科团队，培训跨学科团队，胎盘植入谱外科治疗,未进行产前诊断的胎盘植入谱患者的处理。
结果：在胎盘植入频谱管理的所有问题上达成共识。解决了低收入和中等收入国家的具体问题，试图建立训练有素的胎盘植入光谱跨学科团队的建设指南，以及在有限的资源环境中合理使用不同的治疗方案。此外,强调需要促进受这种疾病影响的患者与跨学科群体之间的接触，克服一些卫生系统典型的行政障碍。
结论：我们就中低收入国家胎盘植入谱的治疗达成共识，根据当地专家的意见。在资源有限的环境中，构建高质量的科学证据至关重要。
