Management of pregnancies complicated by placenta accreta spectrum utilizing a multidisciplinary care team in a rural state.
J Matern Fetal Neonatal Med
; 35(25): 5964-5969, 2022 Dec.
Article
en En
| MEDLINE
| ID: mdl-33769169
ABSTRACT
PURPOSE:
To compare maternal and neonatal outcomes following the development of a multidisciplinary care team for the management of pregnancies complicated by placenta accreta spectrum (PAS) in a rural state.METHODS:
This is a retrospective cohort study evaluating pregnancies managed before PAS team care management formation (2010-2015) and after (2016-2020) in a university medical center. Maternal and neonatal outcomes were analyzed. Patients were grouped by delivery date to either before or after dedicated PAS team formation. Maternal and neonatal outcomes were analyzed. Frequencies and percentages were reported for categorical measures while means and standard deviations were computed for continuous measures. Wilcoxon rank-sum test was used for continuous variables while Chi-square or Fisher's exact was used for categorical measures.FINDINGS:
There were 82 patients with PAS managed at our institution (29 in Pre-PAS team group and 53 in Post-PAS team group). The number of units of packed red blood cells (PRBCS) transfused intraoperatively was significantly higher in the Pre-PAS care team group (6.52 vs. 3.26, p = .0057). The total number of units PRBCS transfused (9.93 vs. 3.51, p = .0014) and total number of cryoprecipitate transfused (0.77 vs. 0.08, p = .0225) during the entire hospital stay were increased in the Pre-PAS team group. Median neonatal 1 min and 5 min APGAR scores were lower in the Pre-PAS care team group (2 vs 6 at 1 min, p = .0035; 6 vs. 7at 5 min, p = .0301).CONCLUSIONS:
Management of PAS by a dedicated, multidisciplinary team results in less blood transfusion requirements and improved maternal and neonatal outcomes.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Placenta Accreta
Tipo de estudio:
Observational_studies
Límite:
Female
/
Humans
/
Newborn
/
Pregnancy
Idioma:
En
Revista:
J Matern Fetal Neonatal Med
Asunto de la revista:
OBSTETRICIA
/
PERINATOLOGIA
Año:
2022
Tipo del documento:
Article
País de afiliación:
Estados Unidos