Colombian Consensus on the Treatment of Placenta Accreta Spectrum (PAS)

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Surgical Management

Background:

• Placenta accreta spectrum (PAS) is a significant cause of postpartum hemorrhage and maternal mortality.
• Existing management guidelines from high-income countries are challenging to implement in low- and middle-income countries.
• There is a need for context-specific recommendations for PAS management in Colombia.

Purpose of the Study:

• To develop general recommendations for the treatment of placenta accreta spectrum (PAS) in Colombia.
• To adapt international best practices to the resource limitations of a middle-income country.
• To establish a framework for improved clinical outcomes in pregnant women with PAS.

Main Methods:

• A modified Delphi methodology was employed, involving 23 panelists and 31 questions.
• Two rounds of discussion and consensus-building were conducted.
• Panelists were selected based on hospital resource and capability assessments.

Main Results:

• Five key recommendations were drafted, addressing early detection, referral pathways, and specialized care.
• Emphasis was placed on establishing regional referral centers with trained interdisciplinary teams.
• Recommendations include specific protocols for timing of delivery, surgical interventions, and the use of telemedicine.

Conclusions:

• This consensus provides the first set of PAS management recommendations tailored for Colombia.
• The recommendations aim to improve clinical outcomes for women with PAS.
• Further research is needed to evaluate the applicability and effectiveness of these guidelines.