Jessian L Munoz1,2, Alison M Kimura1,2, Elly Xenakis1,2, Donald H Jenkins3, Maxwell A Braverman3, Patrick S Ramsey1,2, Kayla E Ireland1,2. 1. Division of Maternal Fetal Medicine,University of Texas Health Sciences Center at San Antonio, San Antonio, TX, USA. 2. Department of Obstetrics & Gynecology, University Health System, San Antonio, TX, USA. 3. Division of Trauma and Emergency Surgery, The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
Abstract
OBJECTIVE: Placenta accreta spectrum (PAS) is a group of placental invasion pathologies associated with significant morbidity to both mother and fetus. The majority of patients with PAS will require a blood transfusion at time of delivery and subsequent cesarean hysterectomy. The optimal approach to maternal acute blood loss resuscitation is currently unknown. METHODS: Here, we present a cohort analysis of 34 patients with pathology-confirmed PAS treated with either whole blood (n = 16) or component therapy (n = 18) for initial intraoperative resuscitation. RESULTS: We observed comparable results in post-operative outcomes with fewer overall transfusions and subsequently, lower volumes of resuscitation (p=.03) with whole blood initial resuscitation. CONCLUSIONS: Whole blood transfusion may represent a viable option for initial resuscitation with lower resuscitation volumes and transfusion-associated complications without directly effecting post-operative outcomes in cases of PAS.
OBJECTIVE: Placenta accreta spectrum (PAS) is a group of placental invasion pathologies associated with significant morbidity to both mother and fetus. The majority of patients with PAS will require a blood transfusion at time of delivery and subsequent cesarean hysterectomy. The optimal approach to maternal acute blood loss resuscitation is currently unknown. METHODS: Here, we present a cohort analysis of 34 patients with pathology-confirmed PAS treated with either whole blood (n = 16) or component therapy (n = 18) for initial intraoperative resuscitation. RESULTS: We observed comparable results in post-operative outcomes with fewer overall transfusions and subsequently, lower volumes of resuscitation (p=.03) with whole blood initial resuscitation. CONCLUSIONS: Whole blood transfusion may represent a viable option for initial resuscitation with lower resuscitation volumes and transfusion-associated complications without directly effecting post-operative outcomes in cases of PAS.