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Original research
Gynecologic oncologists in surgery for placenta accreta spectrum: a survey for practice, experience, and interest
  1. Koji Matsuo1,2,
  2. Nicole L Vestal1,3,
  3. Alesandra R Rau1,3,
  4. Rauvynne N Sangara4,
  5. Ariane C Youssefzadeh1,
  6. Liat Bainvoll1,3,
  7. Shinya Matsuzaki1,
  8. Lynda D Roman1,2,
  9. Joseph G Ouzounian4 and
  10. Jason D Wright5
  1. 1Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California, USA
  2. 2Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California, USA
  3. 3Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
  4. 4Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA
  5. 5Division of Gynecologic Oncology, Department of Obstetrics and gynecology, Columbia University College of Physicians and Surgeons, New York City, New York, USA
  1. Correspondence to Dr Koji Matsuo, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA 90007, USA; koji.matsuo{at}med.usc.edu

Abstract

Objective Surgery for placenta accreta spectrum is associated with significant maternal morbidity and mortality. The role of gynecologic oncologists in the surgical management of placenta accreta spectrum is currently under investigation. This study examined the practices, experiences, and interests of gynecologic oncologists in placenta accreta spectrum surgeries.

Methods The intervention was an anonymous, cross-sectional, 20-question survey sent to 1084 members of the Society of Gynecologic Oncology in the USA.

Results A total of 184 gynecologic oncologists responded to the survey (response rate 17.0%). Most participating gynecologic oncologists have been practicing for >10 years after fellowship (53.2%), practice in urban-teaching hospitals (84.8%) with delivery volumes ≥3000/year (54.3%), and have a multidisciplinary approach (82.5%). Three-quarters (78.7%) feel that the rate of placenta accreta spectrum is increasing over time. One-third (35.5%) perform ≥6 hysterectomies for placenta accreta spectrum yearly. Less than half (45.5%) practice conservative management. Approximately half are involved from the beginning of the case (49.7%) and perform the surgery in the main operating room (59.4%). Almost three-quarters (71.6%) have experienced surgical blood loss >5 L and one-third (36.6%) have experienced cases with blood loss >10 L. About half (50.3%) of participants are interested in placenta accreta spectrum surgery for future practice. Gynecologic oncologists engaging in a multidisciplinary approach are more likely to practice in an urban-teaching hospital, have higher surgical volume, be involved from the beginning of the case, and be interested in placenta accreta spectrum surgery. Those >10 years post-training and in the Southern US region are more likely to practice conservative management or delayed hysterectomy.

Conclusion This society-based cross-sectional survey suggests that gynecologic oncologists are actively involved in the surgical management of placenta accreta spectrum in the USA. Nearly half of gynecologic oncologists who responded to the survey expressed interest in surgery for placenta accreta spectrum.

  • hysterectomy
  • surgery
  • surgical procedures, operative

Data availability statement

Data are available upon reasonable request. Completely deidentified data are available upon reasonable request and approval by the University of Southern California Institutional Review Board and obtained Data Use Agreement.

https://doi.org/10.1136/ijgc-2022-003830

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    Data availability statement

    Data are available upon reasonable request. Completely deidentified data are available upon reasonable request and approval by the University of Southern California Institutional Review Board and obtained Data Use Agreement.

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    Footnotes

    • Contributors Conceptualization: KM, JDW. Data curation: KM, NLV. Formal analysis: KM. Funding acquisition: KM, LDR. Investigation: all authors. Methodology: KM, NLV, RNS. Project administration: KM. Resources: KM, NLV. Software: KM, NLV. Supervision: LDR, JGO, JDW. Validation: KM. Visualization: KM. Writing - original draft: KM. Writing - review and editing: all authors. Guarantor: KM.

    • Funding Ensign Endowment for Gynecologic Cancer Research (KM). The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

    • Competing interests All were unrelated to the work: Consultant, Clovis Oncology, research grant, Merck, royalties, UpToDate (JDW); consultant, Quantgene (LDR); research grant, Merck (SM); none for others.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.