• Helena C Bartels, Karen M Mulligan, Simon Craven, Ailin C Rogers, Shane Higgins, Donal J O'Brien, Ruaidhri McVey, Peter McParland, Jennifer M Walsh, Stephen Carroll, Siobhan Corcoran, Mike Robson, Rhona Mahony, Paul Downey, David Brophy, Gabrielle Colleran, Fionnuala M McAuliffe, and Donal J Brennan.
• National Maternity Hospital, Holles Street, Dublin 2, Ireland.
• Ir J Med Sci. 2021 Nov 1; 190 (4): 1451-1457.

AimThe purpose of this study is to compare maternal outcomes in patients with placenta accreta spectrum (PAS) when managed as part of a multi-disciplinary team (MDT) compared to standard care.MethodsPatients in the standard care group were retrospectively identified from pathology records, with patients in the MDT group prospectively collected on an electronic database. Data on maternal demographics, delivery, estimated blood loss (EBL), transfusion requirements, and morbidity were recorded.ResultsSixty patients were diagnosed with PAS between 2006 and 2019, of whom 32 were part of the standard care group and 28 in the MDT group. Compared to standard care, MDT care was associated with an increase in antenatal diagnosis from 56.3 to 92.9% (p < 0.0001), a significant reduction in EBL (4150 mL (800-19500) vs 1975 (495-8500), p < 0.0001), and transfusion requirements (median 7 (0-30) units of RCC vs 1 (0-13), p < 0.0001).ConclusionPAS is associated with significant maternal morbidity and warrants management in an MDT setting with specialist input, which is associated with improved outcomes.© 2021. Royal Academy of Medicine in Ireland.

14 keywords...

hide…