Abstract
INTRODUCTION: Placenta accreta spectrum (PAS) affects 1/272 deliveries with a mortality rate of 7%, which is often related to life-threatening hemorrhage. Morbidity related to PAS is often due to complications such as hemorrhage requiring blood transfusion, intensive care unit (ICU) admission, and prolonged hospital stay. The American College of Obstetricians and Gynecologists supports a multidisciplinary approach to management of pregnancies complicated by PAS, and as such our protocol for management of PAS was started in 2016. Our approach to the management of PAS includes a high-risk navigation team, monthly multidisciplinary team meetings, early admission for surgical planning, a dedicated team with 24-hour coverage, blood bank specialist involvement at the time of surgery, the availability of backup surgeons, and coordination with other surgical subspecialties. METHODS: This project is a quality review of outcomes of 216 females between 2016 and 2023. Using linear regression analysis, we evaluated four primary outcomes: quantitative blood loss (QBL), blood products transfusion (BPT), length of stay (LOS), and ICU admissions. RESULTS: Linear regression outcomes showed that our QBL, BPT, and LOS among non-ICU patients is lower than the national average and within national average among those admitted to the ICU, with the exception of BPT. Finally, placenta pathology and location may not be a major factor negatively affecting surgical outcomes among PAS patients in a structured program and should be a factor considered when developing PAS centers. CONCLUSION: Our findings from our quality review support the use of a multidisciplinary and surgically structured approach for managing patients with PAS.
Published Version
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