A Systematic Multidisciplinary Initiative May Reduce the Need for Blood Products in Patients With Abnormally Invasive Placenta

J Matern Fetal Neonatal Med. 2020 Feb 23;1-7. doi: 10.1080/14767058.2020.1731460. Online ahead of print.

Abstract

Introduction: The main complication of the abnormally invasive placenta is massive bleeding, with transfusions required frequently. We aim to evaluate the impact of interdisciplinary management on transfusion practices in women with abnormally invasive placenta.Methodology: Clinical outcomes of women with abnormally invasive placenta treated between 2011 and 2019 were reviewed, including transfusion frequency. Patients divided into three groups: group A (women treated before the introduction of interdisciplinary management), group B (women attended to by a fixed interdisciplinary group), and group C (women with no accreta prenatal diagnosis).Results: Patients with prenatal diagnosis and attended by a fixed interdisciplinary group (group B) required fewer units of red blood cells to be prepared and transfused (median number of units, 0 versus 2 in group A and 3 in group C).Conclusion: The participation of an interdisciplinary group, with strict standards for transfusion, reduces the frequency of use of blood substitutes during the care of women with abnormally invasive placenta.

Keywords: Placenta diseases; blood banks; blood component transfusion; multidisciplinary team; placenta accreta; transfusion medicine.