Literature DB >> 33449329

Maternal morbidity in placenta accreta spectrum following introduction of a multi-disciplinary service compared to standard care: an Irish perspective.

Helena C Bartels1, Karen M Mulligan1, Simon Craven1, Ailin C Rogers2, Shane Higgins1, Donal J O'Brien1, Ruaidhri McVey1, Peter McParland1, Jennifer M Walsh1, Stephen Carroll1, Siobhan Corcoran1, Mike Robson1, Rhona Mahony1, Paul Downey1, David Brophy1, Gabrielle Colleran1, Fionnuala M McAuliffe1,3, Donal J Brennan4,5.   

Abstract

AIM: The 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.
METHODS: Patients 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.
RESULTS: Sixty 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).
CONCLUSION: PAS is associated with significant maternal morbidity and warrants management in an MDT setting with specialist input, which is associated with improved outcomes.

Entities:  

Keywords:  Blood loss; Multi-disciplinary team care;Morbidity; Placenta accreta spectrum

Year:  2021        PMID: 33449329     DOI: 10.1007/s11845-020-02473-3

Source DB:  PubMed          Journal:  Ir J Med Sci        ISSN: 0021-1265            Impact factor:   1.568


  6 in total

1.  Maternal and fetal outcomes in placenta accreta after institution of team-managed care.

Authors:  Abdulla Al-Khan; Vivek Gupta; Nicholas P Illsley; Ciaran Mannion; Christopher Koenig; Adam Bogomol; Manuel Alvarez; Stacy Zamudio
Journal:  Reprod Sci       Date:  2013-12-13       Impact factor: 3.060

2.  Risk factors for placenta accreta.

Authors:  T H Hung; W Y Shau; C C Hsieh; T H Chiu; J J Hsu; T T Hsieh
Journal:  Obstet Gynecol       Date:  1999-04       Impact factor: 7.661

3.  Invasive placental disease: the impact of a multi-disciplinary team approach to management.

Authors:  John C Smulian; Ana-Liza Pascual; Helai Hesham; Emma Qureshey; M Bijoy Thomas; Amy M Depuy; Amanda B Flicker; William E Scorza
Journal:  J Matern Fetal Neonatal Med       Date:  2016-08-18

4.  Striking decrease in blood loss with a urologist-assisted standardized multidisciplinary approach in the management of abnormally invasive placenta.

Authors:  Zeljka Lekic; Ehab Ahmed; Ralph Peeker; Tommy Sporrong; Ove Karlsson
Journal:  Scand J Urol       Date:  2017-07-21       Impact factor: 1.612

5.  Placenta accreta: changing clinical aspects and outcome.

Authors:  J A Read; D B Cotton; F C Miller
Journal:  Obstet Gynecol       Date:  1980-07       Impact factor: 7.661

6.  Optimal management strategies for placenta accreta.

Authors:  A G Eller; T F Porter; P Soisson; R M Silver
Journal:  BJOG       Date:  2009-02-04       Impact factor: 6.531

  6 in total

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