{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T15:42:55Z","timestamp":1788536575440,"version":"build-2803163510"},"reference-count":22,"publisher":"Georg Thieme Verlag KG","issue":"08","license":[{"start":{"date-parts":[[2022,7,10]],"date-time":"2022-07-10T00:00:00Z","timestamp":1657411200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:p>\n            Objective\u2003The aim of the study is to describe a model of care and outcomes for placenta accreta spectrum (PAS) implemented in the context of a community based non-academic health system.<\/jats:p><jats:p>\n            Study Design\u2003The program for management of PAS includes a multidisciplinary team approach with protocols for ultrasound assessment, diagnosis, and surgery. The program was implemented in the two largest private hospitals in the Twin Cities, Minnesota, United States. Maternal and fetal outcomes as well as cost were compared for histopathologic confirmed PAS cases before (2007\u20132014, n\u2009=\u200941) and after (2015\u20132017, n\u2009=\u200926) implementation of the PAS program.<\/jats:p><jats:p>\n            Results\u2003Implementation of the PAS program was associated with ICU admission reductions from 53.7 to 19.2%, p\u2009=\u20090.005; a decrease of 1,682\u2009mL in mean estimated blood loss (EBL) (p\u2009=\u20090.061); a decrease in transfusion from 85.4 to 53.9% (p\u2009=\u20090.005). The PAS program also resulted in a (non-significant) decrease in both surgical complications from 48.8 to 38.5% (p\u2009=\u20090.408) and postoperative complications from 61.0 to 42.3% (p\u2009=\u20090.135). The total cost of care for PAS cases in the 3 years after implementation of the program decreased by 33%.<\/jats:p><jats:p>\n            Conclusion\u2003The implementation of a model of care for PAS led by a perinatology practice at a large regional non-academic referral center resulted in reductions of ICU admissions, operating time, transfusion, selected surgical complications, overall postoperative complications, and cost.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/s-0042-1749664","type":"journal-article","created":{"date-parts":[[2022,7,11]],"date-time":"2022-07-11T09:27:17Z","timestamp":1657531637000},"page":"1008-1018","source":"Crossref","is-referenced-by-count":3,"title":["Implementation and Outcomes of a Model of Care for Placenta Accreta Spectrum in a Community-Based Private Practice"],"prefix":"10.1055","volume":"41","author":[{"given":"William","family":"Wagner","sequence":"additional","affiliation":[{"name":"Minnesota Perinatal Physicians, Allina Health, Minneapolis, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Loichinger","sequence":"additional","affiliation":[{"name":"Minnesota Perinatal Physicians, Allina Health, Minneapolis, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abbey C.","family":"Sidebottom","sequence":"additional","affiliation":[{"name":"Care Delivery Research, Allina Health, Minneapolis, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Whitney L.","family":"Wunderlich","sequence":"additional","affiliation":[{"name":"Care Delivery Research, Allina Health, Minneapolis, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Vacquier","sequence":"additional","affiliation":[{"name":"Care Delivery Research, Allina Health, Minneapolis, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theresa","family":"Jentink","sequence":"additional","affiliation":[{"name":"Minnesota Perinatal Physicians, Allina Health, Minneapolis, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marijo N.","family":"Aguilera","sequence":"additional","affiliation":[{"name":"Health Partners Maternal Fetal Medicine, St. Paul, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sureshbabu N.","family":"Ahanya","sequence":"additional","affiliation":[{"name":"Minnesota Perinatal Physicians, Allina Health, Minneapolis, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Morgan","sequence":"additional","affiliation":[{"name":"Maternal Fetal Medicine, Department of Obstetrics, Gynecology, and Women's Health, University of Minnesota, Minneapolis, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meiling","family":"Parker","sequence":"additional","affiliation":[{"name":"Health Partners Maternal Fetal Medicine, St. Paul, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald D.","family":"Wothe","sequence":"additional","affiliation":[{"name":"Health Partners Maternal Fetal Medicine, St. Paul, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2022,7,10]]},"reference":[{"issue":"05","key":"ref1","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1016\/j.ajog.2010.09.013","article-title":"Placenta accreta","volume":"203","author":"M A Belfort","year":"2010","journal-title":"Am J Obstet Gynecol"},{"issue":"05","key":"ref2","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1016\/j.ajog.2014.11.018","article-title":"Center of excellence for placenta accreta","volume":"212","author":"R M 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