O&G Cases · Pre-pregnancy and antenatal care — placental disorders
Consent for caesarean hysterectomy in placenta accreta spectrum — communication station
Simulated-patient communication station: counselling and consent for planned caesarean hysterectomy in placenta accreta spectrum. Tests shared decision-making, breaking difficult news about permanent loss of fertility, honest presentation of uterine-preservation evidence, and safety-netting for antepartum bleeding. Includes assessor timeline, marking domains, assessor key and fail criteria.
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Target exams
Station brief
Format. Simulated-patient communication station, approximately 12 minutes, with 4 minutes reading. You are the obstetric registrar in the multidisciplinary placenta accreta spectrum clinic. A consultant is available but not in the room. The assessor observes and does not prompt unless the candidate stalls. [1]
Candidate instruction. Counsel this woman about her diagnosis and the recommended plan for birth, obtain informed consent for a planned caesarean with likely hysterectomy, discuss whether her uterus can be preserved, and agree a safety plan for the next few weeks. [1][3]
References7ShowHide
- [1]Jauniaux E, Bhide A, Hussein AM, et al. Placenta Praevia and Placenta Accreta Spectrum: Diagnosis and Management: Green-Top Guideline No. 27a BJOG, 2026.PMID 42374711
- [2]Silver RM, Landon MB, Rouse DJ, et al. Maternal morbidity associated with multiple repeat cesarean deliveries Obstet Gynecol, 2006.PMID 16738145
- [3]Shamshirsaz AA, Fox KA, Salmanian B, et al. Maternal morbidity in patients with morbidly adherent placenta treated with and without a standardized multidisciplinary approach Am J Obstet Gynecol, 2015.PMID 25173187
- [4]Sentilhes L, Ambroselli C, Kayem G, et al. Maternal outcome after conservative treatment of placenta accreta Obstet Gynecol, 2010.PMID 20177283
- [5]Zuckerwise LC, Craig AM, Newton JM, et al. Outcomes following a clinical algorithm allowing for delayed hysterectomy in the management of severe placenta accreta spectrum Am J Obstet Gynecol, 2020.PMID 31469990
- [6]Robinson BK, Grobman WA Effectiveness of timing strategies for delivery of individuals with placenta previa and accreta Obstet Gynecol, 2010.PMID 20859146
- [7]Allen L, Jauniaux E, Hobson S, et al. FIGO consensus guidelines on placenta accreta spectrum disorders: Nonconservative surgical management Int J Gynaecol Obstet, 2018.PMID 29405317