Department of Obstetrics and Gynaecology

Six Faculty Members Create New National PAS Disorders Guideline

Jul 19, 2019

Stethoscope and reportsOriginally published by the Society of Obstetricians and Gynaecologists of Canada:

Specialized, interdisciplinary care is the key to good outcomes for mothers with placenta accreta spectrum (PAS) disorders and their babies, according to a new clinical practice guideline from the Society of Obstetricians and Gynaecologists of Canada (SOGC): Screening, Diagnosis, and Management of Placenta Accreta Spectrum Disorders.

PAS disorders, which involve abnormal attachment of the placenta to the wall of the uterus, are a complication of pregnancy that can be life-threatening due to increased risk of bleeding at the time of delivery. Prior Caesarean section or other uterine surgery, advanced maternal age, and placenta previa (a condition where the placenta is positioned in a way that covers the cervix) place women at higher risk of PAS disorders, rates of which are on the rise around the world. It is estimated that 1 in 500 pregnancies in high-resource countries are affected.

“Diagnosis of PAS disorder and subsequent referral to a regional centre dedicated to managing this condition are important for optimizing outcomes for mom and infant,” says Dr. Sebastian Hobson, ObGyn and an author of the guideline. “Ultrasound can be used to identify Caesarean scar pregnancy in the first trimester, as well as placenta previa later in pregnancy. In certain scenarios, magnetic resonance imaging may also be a useful diagnostic tool.” 

The guideline, which is available in the July 2019 edition of the Journal of Obstetrics and Gynaecology Canada, reviews prenatal screening and diagnosis, antenatal care, intraoperative considerations including protocol checklists, and postoperative considerations. Management of retained placenta following vaginal delivery, recurrence risks, and management options in early pregnancy are also discussed. Importantly, the guideline highlights the fact that while many women with PAS disorder receive safe care, more collaborative research is needed on this topic.

Five primary faculty members and one cross-appointed faculty member contributed to this new guideline, including Drs John C. Kingdom (Chair of Department), Sebastian R. Hobson (Assistant Professor), Ally Murji (Assistant Professor), Rory C. Windrim (Professor), Lisa M. Allen (Professor) and Jose C.A. Carvalho (cross-appointed Professor).

Read the new Screening, Diagnosis, and Management of Placenta Accreta Spectrum Disorders guideline here.

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