Are Women Antenatally Diagnosed With Abnormally Invasive Placenta Receiving Optimal Management in England? An Observational Study of Planned Place of Delivery

Abstract

(Acta Obstet Gynecol Scand. 2019;98:337–341) The incidence of abnormally invasive placenta (AIP), a pregnancy complication that is frequently life threatening, has been increasing worldwide. This increase is related to the increasing cesarean delivery rate. Maternal morbidity from AIP is high, due mainly to the complexity of surgery that often requires hysterectomy and is associated with severe hemorrhage. Currently available evidence regarding the treatment of AIP suggests that antenatal diagnosis and care provided by a multidisciplinary team with significant experience in managing these patients can reduce the maternal morbidity associated with AIP. Therefore, it has been recommended that women with AIP be managed at regionalized “specialist centers” where the health care team cares for a substantial volume of patients with this disorder on a regular basis However the current management plans of obstetric units in the United Kingdom when they are confronted with a patient with is unknown. This study aimed to determine the delivery location for women in the United Kingdom with AIP to determine whether obstetric centers managed AIP cases at their facility (in-house), referred patients to centers with a higher level of care, and if they considered themselves be an AIP “specialist center.”