• Fusen Huang, Jingjie Wang, Qiuju Xiong, Wenjian Wang, Yi Xu, Jia Zhuo, Qiuling Xia, and Xiaonan Liu.
• Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Chongqing, 400016, China. 793736612@qq.com.
• J Anesth. 2022 Dec 1; 36 (6): 715722715-722.

PurposeThe placenta accreta spectrum (PAS) score calculated by the scoring system may predict patients with PAS. We aim to find the relationship between estimated blood loss and the PAS score. Further, find the inflection point, identify PAS patients with placenta previa who were at risk for major bleeding.MethodsThe PAS patients with placenta previa, as diagnosed by color Doppler ultrasound, were divided into two groups according to their PAS scores using a new scoring system. Blood loss, transfusion requirements, the rate of Intra-Abdominal Balloon Occlusion (IABO), and other indicators were analyzed between groups.ResultsThe estimated blood loss, intraoperative transfusion, postoperative transfusion, operation time, and hospitalization time significantly increased in the group with a PAS score ≥ 9 (P < 0.05). The inflection point analysis revealed that a significant increase in estimated blood loss occurred when the PAS score was beyond 10 (crude) or 6 (adjusted for age, body mass index, and IABO).ConclusionThere was a non-linear relationship between estimated intraoperative blood loss and PAS score. When the PAS score was greater than 9, hemorrhage, the risk of major bleeding, the need for transfusions, and the placement of an abdominal aortic balloon all increase significantly.© 2022. The Author(s) under exclusive licence to Japanese Society of Anesthesiologists.

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