Predictors of massive blood loss in women with placenta accreta

Wright, Jason D.; Pri-Paz, Shai; Herzog, Thomas J.; Shah, Monjri M.; Bonanno, Clarissa; Lewin, Sharyn N.; Simpson, Lynn L.; Gaddipati, Sreedhar; Sun, Xuming; D’Alton, Mary E.; Devine, Philip E.

doi:10.1016/j.ajog.2011.01.040

Cited by 121 publications

(86 citation statements)

References 27 publications

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“…69 Similarly, the median number of units of blood transfused is five 69 and many women require multiple units of blood and other blood products. [69][70][71][72][73] In a series of 76 cases from Utah, 28% had disseminated intravascular coagulation. 70 Maternal morbidity is common and 25-50% of patients are admitted to an intensive care unit.…”

Section: Discussionmentioning

confidence: 99%

Abnormal Placentation

Silver¹

2015

Obstetrics &Amp; Gynecology

415

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Placental disorders such as placenta previa, placenta accreta, and vasa previa are all associated with vaginal bleeding in the second half of pregnancy. They are also important causes of serious fetal and maternal morbidity and even mortality. Moreover, the rates of previa and accreta are increasing, probably as a result of increasing rates of cesarean delivery, maternal age, and assisted reproductive technology. The routine use of obstetric ultrasonography as well as improving ultrasonographic technology allows for the antenatal diagnosis of these conditions. In turn, antenatal diagnosis facilitates optimal obstetric management. This review emphasizes an evidence-based approach to the clinical management of pregnancies with these conditions as well as highlights important knowledge gaps.

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Section: Discussionmentioning

confidence: 99%

Abnormal Placentation

Silver¹

2015

Obstetrics &Amp; Gynecology

415

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“…As much as 30 %, and in some countries more than 50 % of maternal mortality, is due to hemorrhage, primarily in the postpartum period [2][3][4]. The challenge of identifying and reducing risk factors for major obstetric hemorrhage is also relevant in developed countries where these events are increasingly seen [5][6][7], especially because of complications of overinvasive placentation and postpartum hemorrhage (PPH) [8][9][10][11][12].Real-time assessment and/or quantification of blood loss perinatally is notoriously difficult to assess leading to underestimation of the amount of maternal blood loss [13]; therefore, for this analysis it was decided to circumscribe the study population to women with no co-morbidities (e.g., pre-existing maternal anemia) posing potentially catastrophic outcomes and to specify transfusion of C5 packed red blood cells (pRBC) units at birth.Our purpose was to identify the incidence of major obstetric hemorrhage and revisit clinical and peripartum obstetric risk factors, both modifiable and non-modifiable, for major obstetric hemorrhage, and assess related neonatal outcome. …”

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confidence: 99%

mentioning

confidence: 99%

Revisit of risk factors for major obstetric hemorrhage: insights from a large medical center

Helman

Drukker

Fruchtman

et al. 2015

Arch Gynecol Obstet

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“…26,27 Also, Guleria, et al concluded that; risk factors of AIP (abnormal invasive placentation) were placenta previa and previous cesarean delivery, and Thia, et al concluded that depth of invasion in MAP is increased with multiple previous surgery or excessive curettage or infection causing defective decidua basalis. 28,29 D'Antonio, et al concluded that; incidence of AIP increased in past decades due to increasing caesarean section rates and ultrasound has 91% sensitivity and 97% specificity for prediction of all forms of AIP.…”

Section: 23-25mentioning

confidence: 99%

Outcomes and Accuracy of 2D Gray-Scale Ultrasound Scan in Prenatal Diagnosis of Morbid Adherent Placenta

Moniem¹,

Abdelrazak²,

Hussain³

et al. 2015

Gynecol Obstet Res Open J

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Objective: This study designed to evaluate outcomes and accuracy of 2D gray-scale ultrasound scan in prenatal diagnosis of Morbid Adherent Placenta (MAP). Patients and methods: Fifty pregnant women ≥28 weeks gestation with suspected MAP studied. 2D trans-abdominal gray-scale ultrasound scan done for studied women to confirm; placental location and findings suggestive of MAP. Intra-operative findings at delivery compared with pre-operative sonographer findings to evaluate outcomes and accuracy of 2D gray-scale ultrasound scan in prenatal diagnosis of MAP. Results: 56%(28/50) of studied women had difficult placental separation, considerable intraoperative blood loss. Bilateral internal iliac artery ligation done to control bleeding in 28%(14/50), intrauterine compression balloon with placenta bed sutures done in 6%(3/50) and cesarean hysterectomy done in 22%(11/50) of studied women. Best 2D gray-scale ultrasound parameters for detection of difficult placental separation and considerable intraoperative blood loss in studied cases were; abnormal placental lacunae (73.9% sensitivity) and exophytic mass invading bladder (100% specificity & 100% PPV). Best 2D gray-scale ultrasound parameters for detection of emergency hysterectomy were; disruption of uterine serosa-bladder interface (81.8% sensitivity) and exophytic mass invading bladder (94.9% specificity, 66.7% PPV and 84.1% NPV). Conclusion: Antenatal diagnosis of MAP is crucial for; proper counseling for possible surgical complications, multidisciplinary team care and recruitment. Best 2D gray-scale ultrasound parameters for detection of difficult placental separation in studied cases were; exophytic mass invading bladder, while, best 2D gray-scale ultrasound parameters for detection of emergency hysterectomy were; disruption of uterine serosa-bladder interface and exophytic mass invading bladder.

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Predictors of massive blood loss in women with placenta accreta

Cited by 121 publications

References 27 publications

Abnormal Placentation

Abnormal Placentation

Revisit of risk factors for major obstetric hemorrhage: insights from a large medical center

Outcomes and Accuracy of 2D Gray-Scale Ultrasound Scan in Prenatal Diagnosis of Morbid Adherent Placenta

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