biostudies-literatureMcCall SJMedical Research CouncilUniversity of KentuckyFrench Health Ministry under its Clinical Research Hospital Program1676-1685https://www.ebi.ac.uk/biostudies/studies/S-EPMC9544707biostudies-literatureUnknown129(10)<h4>Objective</h4>To compare the management and outcomes of women with placenta accreta spectrum (PAS) in France and the UK.<h4>Design</h4>Two population-based cohorts.<h4>Setting</h4>All obstetrician-led hospitals in the UK and maternity hospitals in eight French regions.<h4>Population</h4>A cohort of 219 women with PAS in France and a cohort of 154 women with PAS in the UK.<h4>Methods</h4>The management and outcomes of women with PAS were compared between the UK and France.<h4>Main outcome measures</h4>Median blood loss, severe postpartum haemorrhage (≥3 l), postpartum infection and damage to surrounding organs.<h4>Results</h4>The management of PAS differed between the two countries: a larger proportion of women with PAS in the UK had a caesarean hysterectomy compared with France (43% vs 26%, p < 0.001), whereas in France a larger proportion of women with PAS received a uterus-preserving approach compared with the UK (36% vs 19%, p < 0.001). The total median blood loss in the UK was 3 l (IQR 1.7-6.5 l), compared with 1 l (IQR 0.5-2.5 l) in France; more women with PAS had a severe postpartum haemorrhage (PPH) in the UK compared with women with PAS in France (58% vs 21%, p < 0.001) [Correction added on 06 May 2022, after first online publication: '24 hour' has been changed to 'total' in the preceding sentence]. There was no difference between the UK and French populations for postpartum infection or organ damage.<h4>Conclusions</h4>The UK and France have very different approaches to managing PAS, with more women in France receiving a uterine-conserving approach and more women in the UK undergoing caesarean hysterectomy. A life-threatening haemorrhage was more common in the UK than in France, which may be the result of differential management and/or the organisation of the healthcare systems. In women with placenta accreta spectrum, severe haemorrhage was more common in the UK than in France.<h4>Tweetable abstract</h4>In women with placenta accreta spectrum, severe haemorrhage was more common in the UK than in France.BJOG : an international journal of obstetrics and gynaecologyPlacenta accreta spectrum - variations in clinical practice and maternal morbidity between the UK and France: a population-based comparative study.PMC9544707AOR12156Kayem GCollins SLKurinczuk JJKnight MSentilhes LMcCall SJRamakrishnan RDeneux-Tharaux CSeco AfalsePlacenta accreta spectrum - variations in clinical practice and maternal morbidity between the UK and France: a population-based comparative study.<h4>Objective</h4>To compare the management and outcomes of women with placenta accreta spectrum (PAS) in France and the UK.<h4>Design</h4>Two population-based cohorts.<h4>Setting</h4>All obstetrician-led hospitals in the UK and maternity hospitals in eight French regions.<h4>Population</h4>A cohort of 219 women with PAS in France and a cohort of 154 women with PAS in the UK.<h4>Methods</h4>The management and outcomes of women with PAS were compared between the UK and France.<h4>Main outcome measures</h4>Median blood loss, severe postpartum haemorrhage (≥3 l), postpartum infection and damage to surrounding organs.<h4>Results</h4>The management of PAS differed between the two countries: a larger proportion of women with PAS in the UK had a caesarean hysterectomy compared with France (43% vs 26%, p < 0.001), whereas in France a larger proportion of women with PAS received a uterus-preserving approach compared with the UK (36% vs 19%, p < 0.001). The total median blood loss in the UK was 3 l (IQR 1.7-6.5 l), compared with 1 l (IQR 0.5-2.5 l) in France; more women with PAS had a severe postpartum haemorrhage (PPH) in the UK compared with women with PAS in France (58% vs 21%, p < 0.001) [Correction added on 06 May 2022, after first online publication: '24 hour' has been changed to 'total' in the preceding sentence]. There was no difference between the UK and French populations for postpartum infection or organ damage.<h4>Conclusions</h4>The UK and France have very different approaches to managing PAS, with more women in France receiving a uterine-conserving approach and more women in the UK undergoing caesarean hysterectomy. A life-threatening haemorrhage was more common in the UK than in France, which may be the result of differential management and/or the organisation of the healthcare systems. In women with placenta accreta spectrum, severe haemorrhage was more common in the UK than in France.<h4>Tweetable abstract</h4>In women with placenta accreta spectrum, severe haemorrhage was more common in the UK than in France.2022-01-01T00:00:00Z2022 Sep2025-04-22T12:13:04.793Z2025-04-06T00:15:20.052ZS-EPMC95447073538424410.1111/1471-0528.17169