Is telehealth useful in the management of placenta accreta spectrum in low‐resource settings? Results of an exploratory survey

Author:

Nieto‐Calvache Albaro José12ORCID,Fox Karin A.3,Jauniaux Eric4,Maya Juliana2,Stefanovic Vedran5,Weizsäcker Katharina6,van Beekhuizen Heleen7,Adu‐Bredu Theophilus89,Collins Sally8,Siaulys Monica10,Hussein Ahmed M.11,Duvekot Johannes12,Aryananda Rozi13,Nieto‐Calvache Alejandro Solo1415,Pajkrt Eva16,Rijken Marcus J.1617,

Affiliation:

1. Departamento de Ginecología y Obstetricia Fundación Valle del Lili, Clínica de Espectro de Acretismo Placentario Cali Colombia

2. Universidad Icesi Cali Colombia

3. University of Texas Medical Branch at Galveston Galveston Texas USA

4. Faculty of Population Health Sciences EGA Institute for Women's Health, University College London (UCL) London UK

5. Department of Obstetrics and Gynecology, Fetomaternal Medical Center Helsinki University Hospital and University of Helsinki Helsinki Finland

6. Department of Obstetrics and Division of Experimental Obstetrics Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt‐Universität zu Berlin, and Berlin Institute of Health, Campus Virchow‐Klinikum and Campus Charité Mitte Berlin Germany

7. Department of Gynecological Oncology Erasmus Medical Center Rotterdam The Netherlands

8. Nuffield Department of Women's and Reproductive Health University of Oxford Oxford UK

9. Komfo Anokye Teaching Hospital Kumasi Ghana

10. Hospital e Maternidade Santa Joana, Centro de Ensino, Pesquisa e Inovação São Paulo São Paulo Brazil

11. Department of Obstetrics and Gynecology University of Cairo Cairo Egypt

12. Department of Obstetrics and Gynecology, Erasmus Medical Center Rotterdam The Netherlands

13. Maternal–Fetal Medicine Division, Obstetrics and Gynecology Department Dr. Soetomo Academic General Hospital, Universitas Airlangga Surabaya Indonesia

14. Universidad Nacional Abierta y a Distancia (UNAD) Cali Colombia

15. Universidad Santiago de Cali Cali Colombia

16. Department of Obstetrics and Gynecology Amsterdam University Medical Centers Amsterdam The Netherlands

17. Julius Global Health University Medical Center Utrecht, Utrecht University Utrecht The Netherlands

Abstract

AbstractObjectiveThe optimal management of placenta accreta spectrum (PAS) requires the participation of multidisciplinary teams that are often not locally available in low‐resource settings. Telehealth has been increasingly used to manage complex obstetric conditions. Few studies have explored the use of telehealth for PAS management, and we aimed evaluate the usage of telehealth in the management of PAS patients in low‐resource settings.MethodsBetween March and April 2023, an observational, survey‐based study was conducted, and obstetricians‐gynecologists with expertise in PAS management in low‐ and middle‐income countries were contacted to share their opinion on the potential use of telehealth for the diagnosis and management of patients at high‐risk of PAS at birth. Participants were identified based on their authorship of at least one published clinical study on PAS in the last 5 years and contacted by email. This is a secondary analysis of the results of that survey.ResultsFrom 158 authors contacted we obtained 65 responses from participants in 27 middle‐income countries. A third of the participants reported the use of telehealth during the management obstetric emergencies (38.5%, n = 25) and PAS (36.9%, n = 24). Over 70% of those surveyed indicated that they had used “informal” telemedicine (phone call, email, or text message) during PAS management. Fifty‐nine participants (90.8%) reported that recommendations given remotely by expert colleagues were useful for management of patients with PAS in their setting.ConclusionTelehealth has been successfully used for the management of PAS in middle‐income countries, and our survey indicates that it could support the development of specialist care in other low resource settings.

Publisher

Wiley

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