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Am J Perinatol 2024; 41(S 01): e486-e493
DOI: 10.1055/a-1905-5079
Original Article

Patient Perception of Care, Outcomes, and Consequences from Placenta Accreta Spectrum: A Survey-Based Study

Scott A. Shainker 
1   Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
2   Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, Boston, Massachusetts
,
Ronald M. Cornely
1   Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
,
Rebecca Astake
1   Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
,
Michele R. Hacker
1   Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
2   Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, Boston, Massachusetts
› Author Affiliations
Funding This work was funded, in part, by unrestricted funding from Gary and Elizabeth Lowe, The Carney Family Charitable Foundation, and the Charles Koch Foundation.This work was conducted with support from Harvard Catalyst | The Harvard Clinical and Translational Science Center (National Center for Advancing Translational Sciences, National Institutes of Health Award UL: 1TR002541) and financial contributions from Harvard University and its affiliated academic health care centers.
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Abstract

Objective Placenta accreta spectrum (PAS) is an obstetric diagnosis that carries significant risks. However, little is known about patient perceptions of care. This study was conducted to describe the patient experience, reported outcomes, and assess geographical variation in PAS care in the United States.

Study Design Partnering with a PAS patient advocacy organization, we conducted an online survey of PAS patients. Perceptions of care and outcomes, and geographic variation were described.

Results We received 108 responses (69% response rate); 103 respondents delivered in the United States. Demographic characteristics were similar across each region. Most (67%) reported at least one prior cesarean delivery and 53% reported placenta previa in the PAS pregnancy. Over half (63%) reported an antenatal suspicion of PAS and 66% of those respondents reported changing their delivery hospital as a result of their antenatal diagnosis. Though not statistically significant, both showed variability across regions (both p ≥0.60). Seventy-five percent of respondents with antenatal diagnosis reported their pregnancy was managed by a dedicated PAS care team, which did not differ by region (p = 0.80). A majority of respondents (75%) felt their PAS care team was prepared for their delivery; this too did not vary across regions (p = 0.97). Many respondents reported at least one physical (63%) or mental health (17%) adverse outcome as a result of their PAS pregnancy.

Conclusion As reported by prior PAS patients, perception of care and outcomes are overall favorable. There are long-term physical and mental adverse consequences reported. Geographical variation is mixed, however, national guidelines are predominately followed.

Key Points

  • Patient perceptions of care and outcomes are overall positive and favorable.

  • Long lasting physical and mental health consequence from PAS pregnancies are commonly seen.

  • Multidisciplinary care is widely adopted for PAS pregnancies.

Keywords

placenta accreta spectrum - patient perception - mental health - patient survey

Supplementary Material



Publication History

Received: 11 February 2022

Accepted: 12 July 2022

Accepted Manuscript online:
20 July 2022

Article published online:
29 September 2022

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