Lack of experience is a main cause of maternal death in placenta accreta spectrum patients
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Outros Autores: | , , , , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UFMG |
Texto Completo: | https://doi.org/10.1111/aogs.14163 http://hdl.handle.net/1843/56828 |
Resumo: | Introduction: Placenta accreta spectrum (PAS) is a serious condition with a mortality as high as 7%. However, the factors associated with this type of death have not been adequately described, with an almost complete lack of publications analyzing the determining factors of death in this disease. The aim of our work is to describe the causes of death related to PAS and to analyze the associated diagnosis and treatment problems.Material and methods: This is an inter-continental, multicenter, descriptive, retrospective study in low- and middle-income countries. Maternal deaths related to PAS between January 2015 and December 2020 were included. Crucial points in the management of PAS, including prenatal diagnosis and details of the surgical treatment and postoperative management, were evaluated.Results: Eighty-two maternal deaths in 16 low- and middle-income countries, on three continents, were included. Almost all maternal deaths (81 cases, 98.8%) were pre ventable, with inexperience among surgeons being identified as the most relevant problem in the process that led to death among 87% (67 women) of the cases who had contact with health services. The main cause of death associated with PAS was hemorrhage (69 cases, 84.1%), and failures in the process leading to the diagnosis were detected among 64.6% of cases. Although the majority of cases received medical attention and 50 (60.9%) were treated at referral centers for severe obstetric disease, problems were identified during treatment in all cases.Conclusions: Lack of experience and inadequate surgical technique are the most frequent problems associated with maternal deaths in PAS. Continuous training of interdisciplinary teams is critical to modify this tendency |
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2023-07-20T23:07:27Z2023-07-20T23:07:27Z2021-04-18100514451453https://doi.org/10.1111/aogs.141630001-6349http://hdl.handle.net/1843/56828Introduction: Placenta accreta spectrum (PAS) is a serious condition with a mortality as high as 7%. However, the factors associated with this type of death have not been adequately described, with an almost complete lack of publications analyzing the determining factors of death in this disease. The aim of our work is to describe the causes of death related to PAS and to analyze the associated diagnosis and treatment problems.Material and methods: This is an inter-continental, multicenter, descriptive, retrospective study in low- and middle-income countries. Maternal deaths related to PAS between January 2015 and December 2020 were included. Crucial points in the management of PAS, including prenatal diagnosis and details of the surgical treatment and postoperative management, were evaluated.Results: Eighty-two maternal deaths in 16 low- and middle-income countries, on three continents, were included. Almost all maternal deaths (81 cases, 98.8%) were pre ventable, with inexperience among surgeons being identified as the most relevant problem in the process that led to death among 87% (67 women) of the cases who had contact with health services. The main cause of death associated with PAS was hemorrhage (69 cases, 84.1%), and failures in the process leading to the diagnosis were detected among 64.6% of cases. Although the majority of cases received medical attention and 50 (60.9%) were treated at referral centers for severe obstetric disease, problems were identified during treatment in all cases.Conclusions: Lack of experience and inadequate surgical technique are the most frequent problems associated with maternal deaths in PAS. Continuous training of interdisciplinary teams is critical to modify this tendencyengUniversidade Federal de Minas GeraisUFMGBrasilMED - DEPARTAMENTO DE GINECOLOGIA OBSTETRÍCIAActa Obstetricia et Gynecologica ScandinavicaPaíses em DesenvolvimentoPesquisaMorte MaternaPlacenta AcretaQualidade da Assistência à SaúdeDeveloping countriesExperienceMaternal deathPlacenta AcretaQuality of healthcareLack of experience is a main cause of maternal death in placenta accreta spectrum patientsinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttps://obgyn.onlinelibrary.wiley.com/doi/10.1111/aogs.14163Rozi Aditya AryanandaAlbaro J.nieto'calvacheZaman n. JoshuaLina Maria Vergara GalliadiAlejandro s. Nieto'calvacheJosé e. Sanín'blairJuan m Burgos'lunaJose m. Palaios'jaraquemadaGabriel Costa OsananRafael Cortes'charryVidyadhar b. BangalAziz SlaouiAhmed Mohamed AbbasGodwin o. Akabaapplication/pdfinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFMGinstname:Universidade Federal de Minas Gerais (UFMG)instacron:UFMGLICENSELicense.txtLicense.txttext/plain; charset=utf-82042https://repositorio.ufmg.br/bitstream/1843/56828/1/License.txtfa505098d172de0bc8864fc1287ffe22MD51ORIGINALLack of experience is a main cause of maternal death in placenta pdfa.pdfLack of experience is a main cause of maternal death in placenta pdfa.pdfapplication/pdf299124https://repositorio.ufmg.br/bitstream/1843/56828/2/Lack%20of%20experience%20is%20a%20main%20cause%20of%20maternal%20death%20in%20placenta%20pdfa.pdf89a2f80ead0531ab2651edeb3f71c8e7MD521843/568282023-07-21 13:23:40.068oai:repositorio.ufmg.br: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Repositório de PublicaçõesPUBhttps://repositorio.ufmg.br/oaiopendoar:2023-07-21T16:23:40Repositório Institucional da UFMG - Universidade Federal de Minas Gerais (UFMG)false |
dc.title.pt_BR.fl_str_mv |
Lack of experience is a main cause of maternal death in placenta accreta spectrum patients |
title |
Lack of experience is a main cause of maternal death in placenta accreta spectrum patients |
spellingShingle |
Lack of experience is a main cause of maternal death in placenta accreta spectrum patients Rozi Aditya Aryananda Developing countries Experience Maternal death Placenta Acreta Quality of healthcare Países em Desenvolvimento Pesquisa Morte Materna Placenta Acreta Qualidade da Assistência à Saúde |
title_short |
Lack of experience is a main cause of maternal death in placenta accreta spectrum patients |
title_full |
Lack of experience is a main cause of maternal death in placenta accreta spectrum patients |
title_fullStr |
Lack of experience is a main cause of maternal death in placenta accreta spectrum patients |
title_full_unstemmed |
Lack of experience is a main cause of maternal death in placenta accreta spectrum patients |
title_sort |
Lack of experience is a main cause of maternal death in placenta accreta spectrum patients |
author |
Rozi Aditya Aryananda |
author_facet |
Rozi Aditya Aryananda Albaro J.nieto'calvache Zaman n. Joshua Lina Maria Vergara Galliadi Alejandro s. Nieto'calvache José e. Sanín'blair Juan m Burgos'luna Jose m. Palaios'jaraquemada Gabriel Costa Osanan Rafael Cortes'charry Vidyadhar b. Bangal Aziz Slaoui Ahmed Mohamed Abbas Godwin o. Akaba |
author_role |
author |
author2 |
Albaro J.nieto'calvache Zaman n. Joshua Lina Maria Vergara Galliadi Alejandro s. Nieto'calvache José e. Sanín'blair Juan m Burgos'luna Jose m. Palaios'jaraquemada Gabriel Costa Osanan Rafael Cortes'charry Vidyadhar b. Bangal Aziz Slaoui Ahmed Mohamed Abbas Godwin o. Akaba |
author2_role |
author author author author author author author author author author author author author |
dc.contributor.author.fl_str_mv |
Rozi Aditya Aryananda Albaro J.nieto'calvache Zaman n. Joshua Lina Maria Vergara Galliadi Alejandro s. Nieto'calvache José e. Sanín'blair Juan m Burgos'luna Jose m. Palaios'jaraquemada Gabriel Costa Osanan Rafael Cortes'charry Vidyadhar b. Bangal Aziz Slaoui Ahmed Mohamed Abbas Godwin o. Akaba |
dc.subject.por.fl_str_mv |
Developing countries Experience Maternal death Placenta Acreta Quality of healthcare |
topic |
Developing countries Experience Maternal death Placenta Acreta Quality of healthcare Países em Desenvolvimento Pesquisa Morte Materna Placenta Acreta Qualidade da Assistência à Saúde |
dc.subject.other.pt_BR.fl_str_mv |
Países em Desenvolvimento Pesquisa Morte Materna Placenta Acreta Qualidade da Assistência à Saúde |
description |
Introduction: Placenta accreta spectrum (PAS) is a serious condition with a mortality as high as 7%. However, the factors associated with this type of death have not been adequately described, with an almost complete lack of publications analyzing the determining factors of death in this disease. The aim of our work is to describe the causes of death related to PAS and to analyze the associated diagnosis and treatment problems.Material and methods: This is an inter-continental, multicenter, descriptive, retrospective study in low- and middle-income countries. Maternal deaths related to PAS between January 2015 and December 2020 were included. Crucial points in the management of PAS, including prenatal diagnosis and details of the surgical treatment and postoperative management, were evaluated.Results: Eighty-two maternal deaths in 16 low- and middle-income countries, on three continents, were included. Almost all maternal deaths (81 cases, 98.8%) were pre ventable, with inexperience among surgeons being identified as the most relevant problem in the process that led to death among 87% (67 women) of the cases who had contact with health services. The main cause of death associated with PAS was hemorrhage (69 cases, 84.1%), and failures in the process leading to the diagnosis were detected among 64.6% of cases. Although the majority of cases received medical attention and 50 (60.9%) were treated at referral centers for severe obstetric disease, problems were identified during treatment in all cases.Conclusions: Lack of experience and inadequate surgical technique are the most frequent problems associated with maternal deaths in PAS. Continuous training of interdisciplinary teams is critical to modify this tendency |
publishDate |
2021 |
dc.date.issued.fl_str_mv |
2021-04-18 |
dc.date.accessioned.fl_str_mv |
2023-07-20T23:07:27Z |
dc.date.available.fl_str_mv |
2023-07-20T23:07:27Z |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
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article |
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publishedVersion |
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http://hdl.handle.net/1843/56828 |
dc.identifier.doi.pt_BR.fl_str_mv |
https://doi.org/10.1111/aogs.14163 |
dc.identifier.issn.pt_BR.fl_str_mv |
0001-6349 |
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https://doi.org/10.1111/aogs.14163 http://hdl.handle.net/1843/56828 |
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0001-6349 |
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eng |
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eng |
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Acta Obstetricia et Gynecologica Scandinavica |
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openAccess |
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Universidade Federal de Minas Gerais |
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UFMG |
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Brasil |
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MED - DEPARTAMENTO DE GINECOLOGIA OBSTETRÍCIA |
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Universidade Federal de Minas Gerais |
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