{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T12:58:07Z","timestamp":1740142687353,"version":"3.37.3"},"reference-count":29,"publisher":"Federa\u00e7\u00e3o das Associa\u00e7\u00f5es de Ginecologia e Obstetr\u00edcia","issue":"12","license":[{"start":{"date-parts":[[2023,12,23]],"date-time":"2023-12-23T00:00:00Z","timestamp":1703289600000},"content-version":"vor","delay-in-days":22,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev Bras Ginecol Obstet"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Objective\u2003To describe a cohort of placenta accreta spectrum (PAS) cases from a tertiary care institution and compare the maternal outcomes before and after the creation of a multidisciplinary team (MDT).<\/jats:p><jats:p>\n          Methods\u2003Retrospective study using hospital databases. Identification of PAS cases with pathological confirmation between 2010 and 2021. Division in two groups: standard care (SC) group \u2013 2010\u20132014; and MDT group \u2013 2015\u20132021. Descriptive analysis of their characteristics and maternal outcomes.<\/jats:p><jats:p>\n          Results\u2003During the study period, there were 53 cases of PAS (24 - SC group; 29 - MDT group). Standard care group: 1 placenta increta and 3 percreta; 12.5% (3\/24) had antenatal suspicion; 4 cases had a peripartum hysterectomy \u2013 one planned due to antenatal suspicion of PAS; 3 due to postpartum hemorrhage. Mean estimated blood loss (EBL) was 2,469\u2009mL; transfusion of packed red blood cells (PRBC) in 25% (6\/24) - median 7.5 units. Multidisciplinary team group: 4 cases of placenta increta and 3 percreta. The rate of antenatal suspicion was 24.1% (7\/29); 9 hysterectomies were performed, 7 planned due to antenatal suspicion of PAS, 1 after intrapartum diagnosis of PAS and 1 after uterine rupture following a second trimester termination of pregnancy. The mean EBL was 1,250\u2009mL, with transfusion of PRBC in 37.9% (11\/29) - median 2 units.<\/jats:p><jats:p>\n          Conclusion\u2003After the creation of the MDT, there was a reduction in the mean EBL and in the median number of PRBC units transfused, despite the higher number of invasive PAS disorders.<\/jats:p>","DOI":"10.1055\/s-0043-1772482","type":"journal-article","created":{"date-parts":[[2023,12,23]],"date-time":"2023-12-23T23:30:32Z","timestamp":1703374232000},"page":"e747-e753","source":"Crossref","is-referenced-by-count":0,"title":["Placenta Accreta Spectrum Disorders \u2013 The Impact of the Creation of a Multidisciplinary Team on Maternal Outcomes in Portugal"],"prefix":"10.61622","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5273-2903","authenticated-orcid":false,"given":"Beatriz","family":"Teixeira","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Centro Hospitalar Universit\u00e1rio de S\u00e3o Jo\u00e3o, Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8464-6594","authenticated-orcid":false,"given":"Pedro Viana","family":"Pinto","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Centro Hospitalar Universit\u00e1rio de S\u00e3o Jo\u00e3o, Porto, Portugal"},{"name":"Department of Anatomy, Faculdade de Medicina, Universidade do Porto, Porto, Portugal"},{"name":"Department of Obstetrics and Gynecology, Faculdade de Medicina, Universidade do Porto, Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0497-5740","authenticated-orcid":false,"given":"Rodrigo","family":"Realista","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Centro Hospitalar Universit\u00e1rio de S\u00e3o Jo\u00e3o, Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3331-8280","authenticated-orcid":false,"given":"Manuela","family":"Silva","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Centro Hospitalar Universit\u00e1rio de S\u00e3o Jo\u00e3o, Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7563-8410","authenticated-orcid":false,"given":"Ant\u00f3nia","family":"Costa","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Centro Hospitalar Universit\u00e1rio de S\u00e3o Jo\u00e3o, Porto, Portugal"},{"name":"Department of Obstetrics and Gynecology, Faculdade de Medicina, Universidade do Porto, Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1459-5300","authenticated-orcid":false,"given":"Ana Paula","family":"Machado","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Centro Hospitalar Universit\u00e1rio de S\u00e3o Jo\u00e3o, Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3141-2844","authenticated-orcid":false,"given":"Marina","family":"Moucho","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Centro Hospitalar Universit\u00e1rio de S\u00e3o Jo\u00e3o, Porto, Portugal"}]}],"member":"47794","published-online":{"date-parts":[[2023,12,23]]},"reference":[{"issue":"01","key":"ref1","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1002\/ijgo.12761","article-title":"FIGO classification for the clinical diagnosis of placenta accreta spectrum disorders","volume":"146","author":"E Jauniaux","year":"2019","journal-title":"Int J Gynaecol Obstet"},{"issue":"03","key":"ref2","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1016\/j.ajog.2019.01.233","article-title":"Prevalence and main outcomes of placenta accreta spectrum: a systematic review and meta-analysis","volume":"221","author":"E Jauniaux","year":"2019","journal-title":"Am J Obstet Gynecol"},{"issue":"03","key":"ref3","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1097\/AOG.0000000000000680","article-title":"Morbidly adherent placenta treatments and outcomes","volume":"125","author":"J L 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