OC02.05: Placenta accreta spectrum clinic: assistance linked to research as a strategy to improve clinical results

Abstract

Objectives: Placenta accreta spectrum (PAS) is a serious pathology. In 2016, the High Obstetric Complexity Unit (HOCU) of Fundaci ón Valle del Lili (FVL) formed an interdisciplinary group specialised for the management of PAS, called the placenta accreta spectrum clinic (PASC), incorporating quality policies and activities from research to healthcare practice. We present the results of this initiative. Methods: the changes presented in the HOCU involved research as a strategy to evaluate and adopt best practices in PAS, make the program visible at the national level, and reward participants for their efforts. The very scarce information available at the Latin American level and the opportunity that FVL had to apply quality policies and carry out the research was quickly evident. We compare the institutional results of the management of PAS in our institution, before (period 1) and after the operation of PASC (period 2). Results: We observed better results in all the parameters observed in period 2. The patients seen in period 2 had a lower volume of intraoperative bleeding (10% lower volume), lower frequency of transfusions (−10%), duration of surgery (−33%) and postoperative hospitalisation (−50%), fewer ureteral injuries (−68%), hospitalisation of neonates (−72%), use of hospital resources (−16.5%), as well as a higher frequency of uterine preservation (+ 139%). Additionally, in period 2, 11 articles were published in indexed scientific journals, 12 exhibitions were held at scientific congresses and new healthcare products (teleconsultation in PAS) and educational products were generated for patients and health professionals. Conclusions: The consolidation of interdisciplinary groups under health care models such as PASC, driven by research, improves clinical results and reduces the consumption of health resources. OC02.06 An effective training program for antenatal diagnosis of placenta accreta spectrum disorder during an epidemic of Caesarean deliveries