Evidence-based guidelines for the management of abnormally invasive placenta: recommendations from the International Society for Abnormally Invasive Placenta.
Collins, Sally L; Alemdar, Bahrin; van Beekhuizen, Heleen Jet al.
2019 • In American Journal of Obstetrics and Gynecology, 220 (6), p. 511 - 526
[en] The worldwide incidence of abnormally invasive placenta is rapidly rising, following the trend of increasing cesarean delivery. It is a heterogeneous condition and has a high maternal morbidity and mortality rate, presenting specific intrapartum challenges. Its rarity makes developing individual expertise difficult for the majority of clinicians. The International Society for Abnormally Invasive Placenta aims to improve clinicians' understanding and skills in managing this difficult condition. By pooling knowledge, experience, and expertise gained within a variety of different healthcare systems, the Society seeks to improve the outcomes for women with abnormally invasive placenta globally. The recommendations presented herewith were reached using a modified Delphi technique and are based on the best available evidence. The evidence base for each is presented using a formal grading system. The topics chosen address the most pertinent questions regarding intrapartum management of abnormally invasive placenta with respect to clinically relevant outcomes, including the following: definition of a center of excellence; requirement for antenatal hospitalization; antenatal optimization of hemoglobin; gestational age for delivery; antenatal corticosteroid administration; use of preoperative cystoscopy, ureteric stents, and prophylactic pelvic arterial balloon catheters; maternal position for surgery; type of skin incision; position of the uterine incision; use of interoperative ultrasound; prophylactic administration of oxytocin; optimal method for intraoperative diagnosis; use of expectant management; adjuvant therapies for expectant management; use of local surgical resection; type of hysterectomy; use of delayed hysterectomy; intraoperative measures to treat life-threatening hemorrhage; and fertility after conservative management.
Disciplines :
Reproductive medicine (gynecology, andrology, obstetrics)
Author, co-author :
Collins, Sally L; Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, UK, The Fetal Medicine Unit, John Radcliffe Hospital, Oxford, UK. Electronic address: sally.collins@wrh.ox.ac.uk
Alemdar, Bahrin; Department of Obstetrics and Gynecology, South General Hospital, Stockholm, Sweden
van Beekhuizen, Heleen J; Department of Gynaecological Oncology, Erasmus Medical Center, Rotterdam, Netherlands
Bertholdt, Charline ; Centre Hospitalier Régional Universitaire de Nancy, Université de Lorraine, France
Braun, Thorsten; Departments of Obstetrics and Division of Experimental Obstetrics, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow-Klinikum and Campus Charité Mitte, Berlin, Germany
Calda, Pavel ; Department of Obstetrics and Gynecology, General Faculty Hospital, Charles University, Prague, Czech Republic
Delorme, Pierre; Port-Royal Maternity Unit, Cochin Hospital, Paris-Descartes University, DHU Risk and Pregnancy, Assistance Publique-Hôpitaux de Paris, Paris, France
Duvekot, Johannes J; Department of Obstetrics and Gynecology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands
Gronbeck, Lene; Department of Obstetrics, Rigshospitalet, University of Copenhagen, Denmark
Kayem, Gilles ; Department of Obstetrics and Gynecology, Hôpital Trousseau, Assistance Publique des Hôpitaux de Paris, Sorbonne University, Paris, France
Langhoff-Roos, Jens; Department of Obstetrics, Rigshospitalet, University of Copenhagen, Denmark
Marcellin, Louis ; Department of Gynecology Obstetrics II and Reproductive Medicine, Hôpitaux Universitaires Paris Centre, Hôpital Cochin, APHP, Sorbonne Paris Cité, Université Paris Descartes, Faculté de Médecine, Paris, France
Martinelli, Pasquale; Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
Morel, Olivier; Centre Hospitalier Régional Universitaire de Nancy, Université de Lorraine, France
Mhallem, Mina; Department of Obstetrics, Cliniques Universitaires Saint-Luc, Brussels, Belgium
Morlando, Maddalena ; Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy, Department of Women, Children and of General and Specialized Surgery, University "Luigi Vanvitelli", Naples, Italy
Noergaard, Lone N; Department of Obstetrics, Rigshospitalet, University of Copenhagen, Denmark
Nonnenmacher, Andreas; Departments of Obstetrics and Division of Experimental Obstetrics, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow-Klinikum and Campus Charité Mitte, Berlin, Germany
Pateisky, Petra; Department of Obstetrics and Gynecology, Division of Obstetrics and Feto-Maternal Medicine, Medical University of Vienna, Vienna, Austria
Petit, Philippe ; Centre Hospitalier Universitaire de Liège - CHU > > Service de gynécologie-obstétrique (CHR)
Rijken, Marcus J; Vrouw & Baby, University Medical Centre Utrecht, Utrecht University, Utrecht, Netherlands
Ropacka-Lesiak, Mariola; Department of Perinatology and Gynecology, University of Medical Sciences, Poznan, Poland
Schlembach, Dietmar; Vivantes Network for Health, Clinicum Neukoelln, Clinic for Obstetric Medicine, Berlin, Germany
Sentilhes, Loïc ; Department of Obstetrics and Gynecology, Hôpital Pellegrin, CHU de Bordeaux, Bordeaux, France
Stefanovic, Vedran; Department of Obstetrics and Gynecology, Fetomaternal Medical Center, Helsinki University Hospital and University of Helsinki, Finland
Strindfors, Gita; Department of Obstetrics and Gynecology, South General Hospital, Stockholm, Sweden
Vangen, Siri; Division of Obstetrics and Gynaecology, Norwegian National Advisory Unit on Women's Health, Oslo University Hospital, Rikshospitalet and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
Weichert, Alexander ; Departments of Obstetrics and Division of Experimental Obstetrics, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow-Klinikum and Campus Charité Mitte, Berlin, Germany
Weizsäcker, Katharina; Departments of Obstetrics and Division of Experimental Obstetrics, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow-Klinikum and Campus Charité Mitte, Berlin, Germany
Chantraine, Frédéric ; Centre Hospitalier Universitaire de Liège - CHU > > Service de gynécologie-obstétrique (CHR)
International Society for Abnormally Invasive Placenta (IS-AIP)
Evidence-based guidelines for the management of abnormally invasive placenta: recommendations from the International Society for Abnormally Invasive Placenta.
We would like to thank the past and present membership of the IS-AIP, formerly the European Working group on AIP (EW-AIP), for their dedication to this international collaboration aimed at improving the outcomes for women affected by AIP worldwide. We would like to thank all of the librarians who assisted with more than 30 searches, especially Ms. Nia Roberts, Librarian at University of Oxford. Pavel Calda is supported by a research grant (RVO-VFN64165) from the Ministry of Health of the Czech Republic.We would like to thank the past and present membership of the IS-AIP, formerly the European Working group on AIP (EW-AIP), for their dedication to this international collaboration aimed at improving the outcomes for women affected by AIP worldwide. We would like to thank all of the librarians who assisted with more than 30 searches, especially Ms. Nia Roberts, Librarian at University of Oxford. Pavel Calda is supported by a research grant (RVO-VFN64165) from the Ministry of Health of the Czech Republic.
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