Placenta accreta spectrum—A single-center retrospective observational cohort study of multidisciplinary management over time

Abstract

Objective: To evaluate whether the results of a previous study that showed a decrease in blood loss and transfusions with a multidisciplinary approach, including a fixed team when delivering women diagnosed with placenta accreta spectrum at Sahlgrenska University Hospital, remained low throughout time, and to investigate hospital stay and maternal and neonatal complications during a time period with varying team structure compared with previous periods. Methods: A retrospective observational cohort study comparing data from medical records including three cohorts of women diagnosed with placenta accreta spectrum between October 2003 and December 2020. Cohort 1 consisted of women delivered before the multidisciplinary approach was introduced. Cohort 2 and cohort 3 were both managed in a multidisciplinary manner, but while cohort 2 was managed by a fixed team, cohort 3 was managed by several different senior specialists. The data were analyzed using Kruskal-Wallis test. Results: Blood loss and need for transfusion were significantly lower for cohort 3 and cohort 2 compared with cohort 1. No significant difference was found between cohort 3 and cohort 2. Conclusion: The multidisciplinary management and surgical method employed at Sahlgrenska University Hospital have lowered blood loss and the need for transfusions, even over time.