title: PAMUS: placenta accreta management across the United States.
abstract: OBJECTIVE
  There is lack of consensus regarding the optimal strategy for management of abnormal placentation. We set out to determine the actual practices of providers across the United States (U.S.).
  
  
  METHODS
  This was a cross-sectional survey of maternal-fetal medicine providers in the U.S. registered with the Society for Maternal Fetal Medicine (SMFM). Questions regarding management strategies for placenta accreta were addressed by the survey. Both univariable and multivariable analyses were performed to determine if a relationship between demographic factors and management strategies exists.
  
  
  RESULTS
  Approximately 64% of responders were male and 62% had been in practice less than or equal to 20 years. The respondents represented all the major regions of the U.S. and the majority had performed one to five cases in the past year. The gestational age at delivery varied by both the number of years in practice and by geographic location. About 35% of providers report the use of ureteral stents and 36% of providers use internal femoral artery balloons though this varied by region. Regional differences and recent experience play a role in whether to attempt placental removal first. Though the majority of providers believe hysterectomy is the only management option for accreta, 32% of providers have attempted conservative management.
  
  
  CONCLUSIONS
  There is wide variation in the actual practices of physicians in the U.S. with regard to management of placenta accreta.
authors.affiliation: Department of Obstetrics and Gynecology, Cedars Sinai Medical Center, Los Angeles, CA 90048, USA. esakofft@gmail.com
authors.forename: Tania F
authors.initials: TF
authors.lastname: Esakoff
authors.forename: Stephanie J
authors.initials: SJ
authors.lastname: Handler
authors.forename: Jesus M
authors.initials: JM
authors.lastname: Granados
authors.forename: Aaron B
authors.initials: AB
authors.lastname: Caughey
mesh_terms: D002983:Clinical Competence / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D005843:Geography; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006176:Gynecology / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D009359:Neonatology / Q000592:standards / Q000706:statistics & numerical data; D009774:Obstetrics / Q000592:standards / Q000706:statistics & numerical data; D010921:Placenta Accreta / Q000453:epidemiology / Q000628:therapy*; D011247:Pregnancy; D011364:Professional Practice / Q000592:standards / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D000078329:Workforce