胎盘植入
医学
指南
中低收入国家
产科
人口
怀孕
医疗保健
重症监护医学
发展中国家
胎盘
环境卫生
经济增长
胎儿
经济
遗传学
生物
病理
作者
Albaro José Nieto‐Calvache,José M. Palacios‐Jaraquemada,Ahmed M. Hussein,Eric Jauniaux,Conrado Milani Coutinho,Marcus J. Rijken
标识
DOI:10.1016/j.bpobgyn.2024.102475
摘要
Placenta accreta spectrum (PAS) can be associated massive intra- and post-operative hemorrhage which when not controlled can lead to maternal death. Important advances have occurred in understanding the pathophysiology and therapeutic options for this condition. The prevalence of PAS at birth is direct association with the cesarean delivery (CD) rate in the corresponding population and is increasing worldwide. Limited health infrastructure in low- and middle-income countries increases the morbidity and mortality of patients with PAS at birth. In many cases, obstetricians working in limited resources settings cannot follow some of the international guideline's recommendations and have to opt for low-cost management procedures. In this review, we describe the particularities of managing PAS care in low- and middle-income countries from of prenatal evaluation of patients at risk of PAS at birth, therapeutic options, and inter-institutional collaboration. We also propose a management protocol based on training of the local obstetric teams rather than on sophisticated technological resources that are almost never available in low-resource scenarios.
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