A nationwide survey of centers with multidisciplinary teams for placenta accreta patient care in Colombia, observational study

Abstract

Introduction

MAP is associated with severe morbidity and maternal mortality. Therefore, it requires that patients with this condition to be attended in centers that have trained personnel and specific infrastructure. We aimed to identify the hospitals in Colombia that count on the minimum amount of medical specialties to manage this pathological condition and describe their general care practices.

Methodology

Observational study in 87 obstetric tertiary care centers in Colombia. The requested information was collected using a predesigned survey, applied to the reported hospitals, and stored in an electronic database.

Results

Eighty-six hospitals were identified as possessing the capacity to care for women with accreta, of which 71 provided information (82.55% compliance). Although 83.09% of hospitals choose to treat patients with accreta, only 36.6% has a fixed group of specialists, 32.21% did not have interventional radiology, 25.36% did not have a blood bank, and 67.79% did not have intraoperative cell recovery devices; 77.46% of the surveyed hospitals had cared for five or fewer patients with accreta per year.

Conclusion

Most hospitals manage a low number of MAP cases per year, which are handled by shift specialists and not by a fixed group of professionals, which increases the difficulty of achieving expertise.

Keywords:

• Placenta accreta
• health surveys
• interdisciplinary communication

Acknowledgements

We would like to thank Dr. Francisco Edna and María Constanza Vargas, improvement and standardization coordinator, Fundación Valle de Lili. We would also like to thank the participating hospitals and clinics: Antioquia: Clínica Bolivariana, Hospital General de Medellín, Clínica del Prado, Fundación Hospitalaria San Vicente de Paul, E.S.E Hospital Manuel Uribe Ángel, Clínica el Rosario Sede el Tesoro, Clínica promotora Zona Franca Urabá S.AS, Atlántico: Clínica Iberoamericana, Hospital Universidad del Norte, Clínica Reina Catalina S.A.S, Clínica Porto Azul, S.A, Clínica Misericordia. Bogotá D.C: Unidad de Servicios de Salud Simón Bolívar, Unidad de Servicios de Salud Occidente Kennedy, Sociedad de Cirugía Hospital San José, Hospital Universitario Mayor-Mederi, Hospital Universitario San Ignacio, Hospital Universitario San Rafael, Hospital Militar Central, Hospital Infantil Universitario San José, Hospital Central de la Policía Nacional, Fundación Santa Fe de Bogotá, Hospital Universitario de la Samaritana, Clínica Palermo, Clínica del Occidente S.A, Clínica del Country , Clínica Marly. Bolívar: Clínica Cartagena del Mar, Santa Cruz Boca Grande, Clínica de Maternidad Rafael Calvo. Boyacá: Clínica Medilaser, E.S.E, Hospital San Rafael. Cauca: Hospital San José, Clínica la estancia S.A. César: Hospital Rosario Pumarejo, Clínica Valledupar, Clínica Laura Daniela S.A. Córdoba : Hospital San Jerónimo, Fundación Amigos de la Salud, Clínica Valle del Sinú, Clínica Zayma S.A.S Guajira: Clínica Cedes. Huila: Hospital Universitario HMP, Clínica UROS S.A, Clínica Medilaser S.A.Magdalena: Hospital Universitario Fernando Troconis, Clínica de la mujer, Clínica la Milagrosa S.A, Clínica Benedicto S.A. Nariño: Fundación Hospital San Pedro. Norte de Santander: Clínica San José de Cúcuta S.A., Clínical Medical Duarte. Risaralda: Clínica Comfamiliar, Megacentro de alta complejidad San Rafael, E.S.E Hospital Universitario Erasmo Meoz.Santander: Clínica Chicamocha S.A. Sucre: Clínica Santa María, Clínica Especializada la Concepción S.A.S.Tolima: Clínica Tolima. Valle del Cauca: Fundación Valle del Lili, Centro Médico Imbanaco, Fundación Hospital San José, E.S.E. Hospital Universitario Del Valle Evaristo García Empresa Social Del Estado, Clínica San Francisco S.A., Clínica Rey David, Clínica Mariangel Dumian Medical, Clínica Farallones S.A, Clínica Colombia. ,

Disclosure statement

The authors report no conflict of interest.

There was no risk involved in this study, and it was not considered to be a clinical investigation but a quality review; therefore, it was exempted from being submitted to the institutional ethics committee.