{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T09:12:39Z","timestamp":1790845959006,"version":"4.1.0"},"reference-count":41,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2022,4,29]],"date-time":"2022-04-29T00:00:00Z","timestamp":1651190400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007472","name":"University of Kentucky","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007472","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To compare the management and outcomes of women with placenta accreta spectrum (PAS) in France and the UK.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Two population\u2010based cohorts.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>All obstetrician\u2010led hospitals in the UK and maternity hospitals in eight French regions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>A cohort of 219 women with PAS in France and a cohort of 154 women with PAS in the UK.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The management and outcomes of women with PAS were compared between the UK and France.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Median blood loss, severe postpartum haemorrhage (\u22653\u2009l), postpartum infection and damage to surrounding organs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The management of PAS differed between the two countries: a larger proportion of women with PAS in the UK had a caesarean hysterectomy compared with France (43% vs 26%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), whereas in France a larger proportion of women with PAS received a uterus\u2010preserving approach compared with the UK (36% vs 19%, <jats:italic>p<\/jats:italic>\u00a0&lt;\u20090.001). The total median blood loss in the UK was 3\u00a0l (IQR\u00a01.7\u20136.5\u00a0l), compared with 1\u00a0l (IQR\u00a00.5\u20132.5\u00a0l) in France; more women with PAS had a severe postpartum haemorrhage (PPH) in the UK compared with women with PAS in France (58% vs 21%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) [Correction added on 06 May 2022, after first online publication: \u201824\u00a0hour\u2019 has been changed to \u2018total\u2019 in the preceding sentence]. There was no difference between the UK and French populations for postpartum infection or organ damage.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The UK and France have very different approaches to managing PAS, with more women in France receiving a uterine\u2010conserving approach and more women in the UK undergoing caesarean hysterectomy. A life\u2010threatening haemorrhage was more common in the UK than in France, which may be the result of differential management and\/or the organisation of the healthcare systems.<\/jats:p><\/jats:sec><jats:sec><jats:label\/><jats:p>In women with placenta accreta spectrum, severe haemorrhage was more common in the UK than in France.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>In women with placenta accreta spectrum, severe haemorrhage was more common in the UK than in France.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.17169","type":"journal-article","created":{"date-parts":[[2022,4,5]],"date-time":"2022-04-05T09:41:10Z","timestamp":1649151670000},"page":"1676-1685","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Placenta accreta spectrum \u2013 variations in clinical practice and maternal morbidity between the <scp>UK<\/scp> and France: a population\u2010based comparative study"],"prefix":"10.1111","volume":"129","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0078-7010","authenticated-orcid":false,"given":"Stephen J.","family":"McCall","sequence":"first","affiliation":[{"name":"National Perinatal Epidemiology Unit, Nuffield Department of Population Health University of Oxford  Oxford UK"},{"name":"Universit\u00e9 de Paris CRESS U1153, INSERM, Obstetrical, Perinatal and Pediatric Epidemiology (EPOP\u00e9) Research Team  Paris France"},{"name":"Center for Research on Population and Health, Faculty of Health Sciences American University of Beirut  Beirut Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6561-3321","authenticated-orcid":false,"given":"Catherine","family":"Deneux\u2010Tharaux","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Paris CRESS U1153, INSERM, Obstetrical, Perinatal and Pediatric Epidemiology (EPOP\u00e9) Research Team  Paris 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