Obstetric and Anaesthesia Checklists for the Management of Morbidly Adherent Placenta

Abstract

Objective: To develop an integrated checklist for the management of patients with suspected morbidly adherent placenta (MAP).

Methods: A checklist process was developed incrementally by clinicians in the disciplines of maternal-fetal medicine, gynaecology, medical imaging, and anaesthesia for management of women with suspected MAP.

Results: Over a five-year period of debriefing after individual cases, a comprehensive checklist system was developed. The checklist is activated upon referral if MAP is suspected at an initial maternal-fetal medicine consultation; the process is subsequently guided by a clinical nurse specialist, leading to a standardized program of care.

Conclusions: Having a checklist process facilitates standardized care and optimal communication between specialists, providing team-based care for women with this potentially serious complication of pregnancy.

Keywords: Checklist; disease management; high risk pregnancy; obstetrical anaesthesia; placenta accreta; placental disease.