Friday 20 March 2026
Internal Reference Number: FOI_9240
Date Request Received: 23/02/2026 00:00:00
Date Request Replied To: 16/03/2026 00:00:00
This response was sent via: By Email
Request Summary: Placental Complications, PAS, Hysterectomy Outcomes & Training (2021–2025)
Request Category: Private Individuals
| Question Number 1: Under the Freedom of Information Act 2000, please provide the following information for the last five calendar years (2021–2025), broken down by year. Where counts are small, you may apply your standard disclosure controls in line with your usual practice. How many deliveries recorded ICD-10 codes O73.0 or O73.1 (Retained placenta, with or without haemorrhage)? | |
| Answer To Question 1: Please see our response to Q1,2,3,6,7,11 and 13 attached. To accompany this answer to question 1 please also see the documents listed below:  13559 - FOI_9240 - Maternity Placental Complications 2021-2025 v1 For Issue (2).xlsx | |
| Question Number 2: Of the cases in Question 1, how many also recorded a postpartum haemorrhage (PPH) of 1,000ml or more? | |
| Answer To Question 2: See response to Q1 | |
| Question Number 3: How many deliveries recorded any of the following ICD-10 codes: – O43.21 (placenta accreta) – O43.22 (placenta increta) – O43.23 (placenta percreta) If you are unable to distinguish between these subcodes within your dataset/reporting extract, please confirm whether PAS cases are captured under ICD-10 code O43.2 (Morbidly adherent placenta), and provide the count for O43.2 instead. | |
| Answer To Question 3: See response to Q1 | |
| Question Number 4: Of the PAS-coded cases in Question 3, how many were documented antenatally as “suspected PAS” where this is captured in a structured/reportable way (for example, a specific coded field, dropdown, flag, problem list entry, or other reportable attribute)? If this is not held in a structured/reportable way, please confirm this and briefly state how (if at all) antenatal suspicion is recorded (e.g., free text in ultrasound reports/clinical notes). | |
| Answer To Question 4: The Trust upgraded our electronic patient record system in February 2025 to BadgerNet, prior to this information was recorded on paper notes and would take longer than 18 hours to retrieve. Since February 2025 (recorded on BadgerNet) there fewer than than 6 cases. | |
| Question Number 5: How many women underwent peripartum hysterectomy where the primary recorded indication was PAS or suspected PAS? If available, please differentiate between planned and emergency hysterectomies. | |
| Answer To Question 5: Fewer than 6. | |
| Question Number 6: How many deliveries involved Manual Removal of Placenta (MROP)? | |
| Answer To Question 6: See response to Q1 | |
| Question Number 7: Of the MROP cases in Question 6, how many also recorded a PPH of 1,000ml or more? | |
| Answer To Question 7: See response to Q1 | |
| Question Number 8: Is diagnostic and management training for Placenta Accreta Spectrum (PAS) a mandatory requirement for frontline maternity staff? (Yes/No. If Yes, please specify which staff groups this applies to.) | |
| Answer To Question 8: Yes - This is part of standard training in Obstetrics and Gynaecology but there is no specific teaching given in our Trust. Management of uterine investigation due to Accreta is part of annual training for Midwives. Diagnosis is part of training for all Sonographers. | |
| Question Number 9: In the last 24 months, has the Trust included a PAS-specific scenario (distinct from general haemorrhage) in mandatory Skills & Drills, PROMPT, or other obstetric emergency training? | |
| Answer To Question 9: No - A PAS specific scenario is not part of the general mandatory Skills and Drills training. | |
| Question Number 10: Does the Trust have a written “Hard Stop” protocol for manual removal of a sticky or retained placenta (for example, a defined time limit or limit on number of attempts before escalation to a suspected PAS pathway)? | |
| Answer To Question 10: No. | |
| Question Number 11: In the Trust’s maternity electronic patient record system (or radiology reporting workflow), is antenatal “suspected PAS” captured as: – a structured/coded field or flag (reportable), – free text only, or – not recorded? | |
| Answer To Question 11: Q11 = Suspected PAS is initially recorded as free text in BadgerNet Maternity. If the patient is confirmed as having PAS these details are then recorded in a field also in BadgerNet Maternity. | |
| Question Number 12: Which ultrasound guideline or reporting template does the Trust use when identifying or documenting suspected PAS? (For example, RCOG guidance, FIGO guidance, an internal Trust guideline, or other.) If you refer to any internal policy, guideline, SOP, template, training document, or pathway in your response, please attach a copy (or provide a link to the published version) for reference. | |
| Answer To Question 12: The Trust follows nationally and internationally recognised guidance when identifying and documenting suspected Placenta Accreta Spectrum (PAS). In particular, this includes guidance from the Royal College of Obstetricians and Gynaecologists (RCOG), the International Federation of Gynecology and Obstetrics (FIGO), and the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG). Ultrasound assessment and reporting are undertaken in line with these standards, including the use of recognised sonographic descriptors for PAS (e.g. placental lacunae, loss of the clear zone, myometrial thinning, bladder wall interruption, and abnormal vascularity). In addition to external guidance, the Trust utilises an internal obstetric ultrasound reporting template and local clinical guideline/SOP for suspected PAS. These documents align with national recommendations and support consistent documentation, escalation, and multidisciplinary management planning. For reference, publicly available guidance includes: RCOG Green-top Guideline No. 27a (Placenta Praevia and Placenta Accreta Spectrum) ISUOG Practice Guidelines on placenta accreta spectrum disorders FIGO consensus guidelines on PAS can be found on EOLAS, link is: https://app.eolasmedical.com/organisation/landing/null?organisationId=ORG%23staging-salisbury-nhs-foundation-trust%231120b4c7-8856-4520-934a-f2778c95fc7a&fileId=FILE%2305c8185c-d162-47c1-a5c5-33f51933dd6b&origin=section SOP for Abnormal placenta placement can be found on EOLAS, link is: https://app.eolasmedical.com/organisation/landing/null?organisationId=ORG%23staging-salisbury-nhs-foundation-trust%231120b4c7-8856-4520-934a-f2778c95fc7a&fileId=FILE%23af8078ca-6fb9-4e62-88e1-bc82e6436182&origin=section | |
| Question Number 13: How many deliveries did the Trust record in total in each year (2021–2025)? | |
| Answer To Question 13: See response to Q1 | |
| Please see Attachments: | |
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