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

• Published in: Irish journal of medical science 2021-11, Vol.190 (4), p.1451-1457
• Main Authors: Bartels, Helena C., Mulligan, Karen M., Craven, Simon, Rogers, Ailin C., Higgins, Shane, O’Brien, Donal J., McVey, Ruaidhri, McParland, Peter, Walsh, Jennifer M., Carroll, Stephen, Corcoran, Siobhan, Robson, Mike, Mahony, Rhona, Downey, Paul, Brophy, David, Colleran, Gabrielle, McAuliffe, Fionnuala M., Brennan, Donal J.
• Format: Article
• Language: English
• Subjects: Family Medicine; General Practice; Internal Medicine; Medicine; Medicine & Public Health; Original Article
• ISSN: 0021-1265; 1863-4362
• DOI: 10.1007/s11845-020-02473-3

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.