Whole blood transfusion reduces overall component transfusion in cases of placenta accreta spectrum: a pilot program

Abstract

Objective: Placenta accreta spectrum (PAS) is a group of placental invasion pathologies associated with significant morbidity to both mother and fetus. The majority of patients with PAS will require a blood transfusion at time of delivery and subsequent cesarean hysterectomy. The optimal approach to maternal acute blood loss resuscitation is currently unknown.

Methods: Here, we present a cohort analysis of 34 patients with pathology-confirmed PAS treated with either whole blood (n = 16) or component therapy (n = 18) for initial intraoperative resuscitation.

Results: We observed comparable results in post-operative outcomes with fewer overall transfusions and subsequently, lower volumes of resuscitation (p=.03) with whole blood initial resuscitation.

Conclusions: Whole blood transfusion may represent a viable option for initial resuscitation with lower resuscitation volumes and transfusion-associated complications without directly effecting post-operative outcomes in cases of PAS.

Keywords: Placenta accreta; abnormal placentation; blood transfusion; cesarean hysterectomy; whole blood.