title: Management of placenta accreta: a survey of Maternal-Fetal Medicine practitioners.
abstract: OBJECTIVE
  To describe the management strategies for placenta accreta used by Maternal-Fetal Medicine practitioners.
  
  
  METHODS
  We conducted a 36-question online survey of members of the Society for Maternal-Fetal Medicine regarding management of placenta accreta, and tabulated the results.
  
  
  RESULTS
  We had 508 respondents. Most respondents have been in practice for >20 years (30%), at a university-affiliated institution (58.1%). In the previous 2 years, 44.6% of respondents operated on 1-3 cases of placenta accreta, with 3% having operated on greater than 10 cases. Magnetic resonance imaging (MRI) is used as a diagnostic adjunct when the suspicion for accreta is both low (43.1%) and high (68%). In asymptomatic patients with high suspicion for accreta, 15.4% of practitioners hospitalize patients antenatally, 34.5% administer corticosteroids, and 46.8% perform amniocentesis for fetal lung maturity prior to delivery, which they schedule most commonly at 36 weeks (48.4%). Equipment requested prior to delivery includes intravascular balloon catheters (35%) and ureteral stents or catheters (26.2%). With high suspicion for accreta intraoperatively, the majority proceed with hysterectomy, but 14.9% report conservative management.
  
  
  CONCLUSIONS
  Survey respondents employ diverse approaches in the management of patients with placenta accreta. Further study may lead to consensus strategies to improve outcome in this high-risk obstetric condition.
authors.affiliation: Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of California, Irvine, Orange, CA, USA. jjolley76@gmail.com
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Jolley
authors.forename: Michael P
authors.initials: MP
authors.lastname: Nageotte
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Wing
authors.forename: Vineet K
authors.initials: VK
authors.lastname: Shrivastava
mesh_terms: D002983:Clinical Competence; D003625:Data Collection; D004522:Educational Status; D005260:Female; D005843:Geography; D006176:Gynecology / Q000706:statistics & numerical data; D006771:Hospitals, Maternity / Q000706:statistics & numerical data; D006801:Humans; D007231:Infant, Newborn; D033261:Maternal-Fetal Relations; D009359:Neonatology / Q000706:statistics & numerical data; D009774:Obstetrics / 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; D000078329:Workforce