Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC · 2026
Maternal and Neonatal Outcomes of Placenta Accreta Spectrum Disorders Following Implementation of a Multidisciplinary Management Team.
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Douglas Claire M, Kader Shirmin B, Smith Sarah N
Аннотация
OBJECTIVE: To compare maternal and neonatal outcomes before and after the implementation of a multidisciplinary management team for placenta accreta spectrum (PAS) disorders.
METHODS: This retrospective cohort study reviewed pregnancies complicated by PAS disorders that culminated in delivery at the Regina General Hospital between January 2019 and December 2024. Patients were categorized by delivery date before or after the implementation of a multidisciplinary management team for PAS disorders. The primary outcome was the total units of transfused packed red blood cells (PRBCs). Secondary intraoperative and postoperative maternal and neonatal outcomes were also compared.
RESULTS: Thirty-seven cases of PAS disorders were included (15 pre-implementation and 22 post-implementation). The post-implementation group received fewer units of transfused PRBCs (2 vs. 4, P = 0.175), had higher hemoglobin at discharge (89.14 g/dl vs. 87.93 g/dl, P = 0.839), fewer ICU admissions (2 vs. 4, P = 0.198), fewer postoperative infections (14% vs. 20%, P = 0.670) and a shorter hospital stay after surgery (median of 3 vs. 4 days, P = 0.094), but these differences did not reach statistical significance. General anesthesia was used more frequently post-implementation (59% vs. 27%, P = 0.061). After implementation, neonates had lower Apgar scores at 1 minute (4.68 vs. 6.40, P = 0.061), 5 minutes (6.73 vs. 8.27, P = 0.025) and 10 minutes (6.33 vs. 8.50, p = 0.045) but the neonatal cord arterial pH was similar (7.30 vs. 7.28, P = 0.413).
CONCLUSION: Our findings generally support the use of a multidisciplinary team for managing PAS disorders.
METHODS: This retrospective cohort study reviewed pregnancies complicated by PAS disorders that culminated in delivery at the Regina General Hospital between January 2019 and December 2024. Patients were categorized by delivery date before or after the implementation of a multidisciplinary management team for PAS disorders. The primary outcome was the total units of transfused packed red blood cells (PRBCs). Secondary intraoperative and postoperative maternal and neonatal outcomes were also compared.
RESULTS: Thirty-seven cases of PAS disorders were included (15 pre-implementation and 22 post-implementation). The post-implementation group received fewer units of transfused PRBCs (2 vs. 4, P = 0.175), had higher hemoglobin at discharge (89.14 g/dl vs. 87.93 g/dl, P = 0.839), fewer ICU admissions (2 vs. 4, P = 0.198), fewer postoperative infections (14% vs. 20%, P = 0.670) and a shorter hospital stay after surgery (median of 3 vs. 4 days, P = 0.094), but these differences did not reach statistical significance. General anesthesia was used more frequently post-implementation (59% vs. 27%, P = 0.061). After implementation, neonates had lower Apgar scores at 1 minute (4.68 vs. 6.40, P = 0.061), 5 minutes (6.73 vs. 8.27, P = 0.025) and 10 minutes (6.33 vs. 8.50, p = 0.045) but the neonatal cord arterial pH was similar (7.30 vs. 7.28, P = 0.413).
CONCLUSION: Our findings generally support the use of a multidisciplinary team for managing PAS disorders.