دورية أكاديمية
Placenta accreta spectrum: a non-oncologic challenge for gynecologic oncologists.
العنوان: | Placenta accreta spectrum: a non-oncologic challenge for gynecologic oncologists. |
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المؤلفون: | Touhami O; Gynecologic Oncology Division, Department of Obstetrics and Gynecology, Centre Intégré Universitaire de Santé et Services Sociaux CIUSSS du Saguenay-Lac-Saint-Jean, Sherbrooke University, Sherbrooke, Quebec, Canada touhamiomar@yahoo.fr., Allen L; Department of Obstetrics and Gynecology, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada., Flores Mendoza H; Department of Obstetrics and Gynecology, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada., Murphy MA; Department of Obstetrics and Gynecology, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada., Hobson SR; Department of Obstetrics and Gynecology, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada. |
المصدر: | International journal of gynecological cancer : official journal of the International Gynecological Cancer Society [Int J Gynecol Cancer] 2022 Apr 27. Date of Electronic Publication: 2022 Apr 27. |
Publication Model: | Ahead of Print |
نوع المنشور: | Journal Article; Review |
اللغة: | English |
بيانات الدورية: | Publisher: BMJ Country of Publication: England NLM ID: 9111626 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1525-1438 (Electronic) Linking ISSN: 1048891X NLM ISO Abbreviation: Int J Gynecol Cancer Subsets: MEDLINE |
أسماء مطبوعة: | Publication: 2019- : [London] : BMJ Original Publication: Cambridge, MA, USA : Blackwell Scientific Publications, c1991- |
مستخلص: | Placenta accreta spectrum disorders are a major risk factor for severe postpartum hemorrhage and maternal death worldwide, with a rapidly growing incidence in recent decades due to increasing rates of cesarean section. Placenta accreta spectrum disorders represent a complex surgical challenge, with the primary concern of massive obstetrical hemorrhagic sequelae and organ damage, occurring in the context of potentially significant anatomical and physiological changes of pregnancy. Most international obstetrical organizations have published guidelines on placenta accreta spectrum, embracing the creation of regionalized 'Centers of Excellence' in the diagnosis and management of placenta accreta spectrum, which includes a dedicated multidisciplinary surgical team. One mandatory criterion for these Centers of Excellence is the presence of a surgeon experienced in complex pelvic surgeries. Indeed, many institutions in the United States and worldwide rely on gynecologic oncologists in the surgical management of placenta accreta spectrum due to their experience and skills in complex pelvic surgery. Surgical management of placenta accreta spectrum frequently includes challenging pelvic dissection in regions with distortion of anatomy alongside large aberrant neovascularization. With a goal of definitive management through cesarean hysterectomy, surgeons require a systematic and thoughtful approach to promote prevention of urologic injuries, embrace measures to secure challenging hemostasis and, in selected cases, employ conservative management where indicated or desired. In this review recommendations are made for gynecologic oncologists regarding the management and important considerations in the successful care of placenta accreta spectrum disorders. Where required, gynecologic oncologists are encouraged to be proactively involved in the management of placenta accreta spectrum, not only intra-operatively, but also in the development of clinical protocols, guidelines, and pre-operative counseling of patients, as a 'call if needed' approach is suboptimal for this potentially major and life-threatening condition. Competing Interests: Competing interests: None declared. (© IGCS and ESGO 2022. No commercial re-use. See rights and permissions. Published by BMJ.) |
فهرسة مساهمة: | Keywords: Gynecologic Surgical Procedures; Surgical Procedures, Operative |
تواريخ الأحداث: | Date Created: 20220428 Latest Revision: 20240220 |
رمز التحديث: | 20240220 |
DOI: | 10.1136/ijgc-2021-003325 |
PMID: | 35478092 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1525-1438 |
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DOI: | 10.1136/ijgc-2021-003325 |