{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T15:18:39Z","timestamp":1791559119297,"version":"4.3.4"},"reference-count":22,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,1,4]],"date-time":"2022-01-04T00:00:00Z","timestamp":1641254400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aust NZ J Obst Gynaeco"],"published-print":{"date-parts":[[2022,6]]},"abstract":"Background<\/jats:title>Placenta accreta spectrum (PAS) has a high risk of maternal morbidity, and requires meticulous antenatal and peripartum management.<\/jats:p><\/jats:sec>Aims<\/jats:title>To compare the management and outcomes of PAS between women with and without antenatally suspected disease, and to evaluate the effect of multidisciplinary team (MDT) management.<\/jats:p><\/jats:sec>Materials and methods<\/jats:title>A retrospective cohort study identified all hysterectomy specimens with a histopathological diagnosis of PAS in the Western Sydney Local Health District between January 2006 and December 2019, and analysed each patient\u2019s clinical course.<\/jats:p><\/jats:sec>Results<\/jats:title>Seventy patients had PAS diagnosed on hysterectomy specimens, of which 38 cases (54%) were antenatally suspected. Women with suspected PAS were more likely to have a previous caesarean section (100% vs 68%, P<\/jats:italic>\u00a0<\u00a00.001), placenta praevia (92% vs 56%, P<\/jats:italic>\u00a0<\u00a00.001) and anterior placenta (95% vs 66%. P<\/jats:italic>\u00a0=\u00a00.011). Suspected PAS was associated with less maternal blood loss (median blood loss 2000\u00a0mL vs 4000\u00a0mL, P<\/jats:italic>\u00a0<\u00a00.001), fewer red blood cell transfusions (median four units vs nine units, P<\/jats:italic>\u00a0<\u00a00.001), and shorter intensive care or high dependency unit admission (mean stay one day vs three days, P<\/jats:italic>\u00a0=\u00a00.037). There were no significant differences in other maternal morbidities. MDT management was associated with a clinically significant reduction in maternal blood loss (1500\u00a0mL vs 2520\u00a0mL, P<\/jats:italic>\u00a0=\u00a00.09) and red blood cell transfusion (one unit vs six units, P<\/jats:italic>\u00a0=\u00a00.04). The mean gestation of delivery was 37\u00a0weeks in both groups with no differences in neonatal morbidity.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Both antenatally diagnosed PAS and MDT management reduced blood loss and blood transfusion. Elective delivery at 37\u00a0weeks gestation reduces the neonatal risks of preterm delivery.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajo.13471","type":"journal-article","created":{"date-parts":[[2022,1,5]],"date-time":"2022-01-05T06:54:20Z","timestamp":1641365660000},"page":"376-382","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Placenta accreta spectrum: We can do better"],"prefix":"10.1111","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2928-6191","authenticated-orcid":false,"given":"Cheryl","family":"Silveira","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology Women\u2019s and Newborn Health Westmead Hospital Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrienne","family":"Kirby","sequence":"additional","affiliation":[{"name":"NHMRC Clinical Trials Centre The University of Sydney Sydney 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