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

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The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians


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 ( = 16) or component therapy ( = 18) for initial intraoperative resuscitation. RESULTS: We observed comparable results in post-operative outcomes with fewer overall transfusions and subsequently, lower volumes of resuscitation (=.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.

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