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CME Credit Offered
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Poster Session 3

(757) The Correlation Between Extent of Invasion in Placenta Accreta Spectrum and Units of Blood Transfused

Friday, January 31, 2025
10:30 AM – 12:30 PM  
Objective:

The primary objective of this study is to determine if there is an association between the extent of invasion in Placenta Accreta Spectrum (PAS) as identified on pre-operative imaging and transfusion of packed red blood cells (pRBCs). By establishing this correlation, the study aims to enhance preoperative preparation for patients with PAS and reduce the waste of healthcare resources by avoiding the preparation of unnecessary blood products.

Study Design:

This was a retrospective cohort study, approved by the Institutional Review Board. The study was conducted at a single accreta center of excellence from April 1, 2010 through January 9, 2023. All patients diagnosed pre-operatively with PAS via ultrasound were included. We excluded patients who did not have clear ultrasound diagnosis of PAS with extent of invasion documented. Data was collected from electronic medical records, including maternal demographics, pre-operative ultrasound findings, pre-operative hemoglobin level, blood loss and pRBCs.
Descriptive statistics were used to summarize maternal demographics and clinical outcomes as well as parametric and non-parametric statistics to compare groups. Data analysis was performed using SPSS version 29.0.2.0. P-values < 0.05 was statistically significant.

Results:

Prenatal ultrasound was used to identify 160 patients with PAS with extent of invasion identified as focal accreta (N=9), accreta (N=97), increta (N=29), and percreta (N=25). There were no differences across demographic, age, race, BMI, number of prior cesarean deliveries and preoperative hemoglobin. There were no differences found in units of pRBCs between groups or estimated blood loss.

Conclusion:

In conclusion we found no differences in units of pRBCs transfused and blood loss despite differences in preoperative diagnosis. This may be related to overall increased preparedness at a placenta accreta center of excellence with multi-disciplinary care. This study supports standard protocols and uniformity in available blood despite differences in preoperative diagnosis.