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Diagnostic terminology in Placenta Accreta Spectrum: a scoping review

  • Author Footnotes
    † Denotes joint first authors/equal contribution by authors.
    M.A. Broom
    Correspondence
    Correspondence to: M.A. Broom, Dept. of Anaesthesia, Glasgow Royal Infirmary, Glasgow G4 0SF, UK.
    Footnotes
    † Denotes joint first authors/equal contribution by authors.
    Affiliations
    University of Glasgow, College of Medical, Veterinary and Life Sciences, Glasgow, UK

    Glasgow Royal Infirmary/Princess Royal Maternity Hospital, Glasgow, UK
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  • Author Footnotes
    † Denotes joint first authors/equal contribution by authors.
    E. Bailey
    Footnotes
    † Denotes joint first authors/equal contribution by authors.
    Affiliations
    University of Glasgow, College of Medical, Veterinary and Life Sciences, Glasgow, UK
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  • R.J. Kearns
    Affiliations
    University of Glasgow, College of Medical, Veterinary and Life Sciences, Glasgow, UK

    Glasgow Royal Infirmary/Princess Royal Maternity Hospital, Glasgow, UK
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  • M. McMillan
    Affiliations
    Glasgow Royal Infirmary/Princess Royal Maternity Hospital, Glasgow, UK
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  • J. McPeake
    Affiliations
    University of Glasgow, College of Medical, Veterinary and Life Sciences, Glasgow, UK

    Glasgow Royal Infirmary/Princess Royal Maternity Hospital, Glasgow, UK
    Search for articles by this author
  • Author Footnotes
    † Denotes joint first authors/equal contribution by authors.

      Highlights

      • Reporting of Placenta Accreta Spectrum (PAS) should adhere to standard criteria.
      • Across 62 papers, 30 different terms were used to describe PAS and subtypes.
      • Terminology was only clearly defined or used consistently <50% of the time.
      • Clear diagnostic criteria are not consistently used to justify diagnostic labels.
      • Despite consensus criteria for reporting PAS (2018), language remains inconsistent.

      Abstract

      Background

      Anaesthetic management strategies for Placenta Accreta Spectrum (PAS) remain diverse, and literature interpretation is complicated by a range of terminology. The International Federation for Gynaecology and Obstetrics (FIGO) published guidance in 2018 to improve PAS diagnosis and management by standardising definitions. We mapped the range, clarity and consistency of terminology in literature pertaining to both PAS and anaesthesia, and determined whether this changed followed FIGO guidance.

      Methods

      A literature search of four medical databases was performed. Papers included had PAS (or any ‘synonym’) in the title, and mode of anaesthesia in the title or abstract. Narrative reviews, and papers not containing original data, were excluded. Diagnostic terms, and evidence supporting their use, were described.

      Results

      Among 680 abstracts identified, 62 papers were included. Thirty distinct terms were used to describe PAS and subtypes. Terminology was clearly defined 46% of the time and used consistently within a paper 47% of the time. Nine papers (15%) provided no diagnostic evidence to support the terminology used. In 14 (23%) papers published after FIGO guidelines, 14 terms were used to describe PAS. Two papers (14%) specified the diagnostic criteria used. Six (43%) confirmed diagnoses using pathology. Four (29%) were consistent in use of terminology throughout the paper.

      Conclusions

      Despite international consensus criteria for reporting PAS, the language pertaining to PAS and anaesthesia remains heterogeneous, inconsistent and variably defined. Reporting of PAS should adhere to FIGO criteria to allow unambiguous interpretation of work, and generation of evidence that is transferrable into clinical practice.

      Keywords

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