Effect of a placenta accreta spectrum multidisciplinary team and checklist on maternal outcomes for planned hysterectomy at time of cesarean delivery

Abstract

Evidence suggests that multidisciplinary teams that perform cesarean hysterectomy for placenta accreta spectrum have better maternal outcomes. The aim of this study was to assess the effects of a multidisciplinary team on outcomes for patients with placenta accreta spectrum at our institution. We examined all planned cesarean hysterectomy procedures performed for placenta accreta syndrome at our hospital between July 1, 2015, and June 30, 2021. Nine and 21 subjects had planned cesarean hysterectomy before and after implementation of the new procedures, respectively. Overall, there was an increase in volume of cases and depth of placental invasion but no change in the demographic characteristics of patients. Additionally, we found decreased blood loss, decreased blood transfusions from a median of 2 units to 0 units, and decreased intensive care unit admission rates from 22.2% to 4.8%, but these results did not reach statistical significance. The main limitation of our study was our small number of subjects. Our findings suggest that multidisciplinary placenta accreta teams improve maternal outcomes for hysterectomy at the time of cesarean delivery.

Keywords:

• Blood transfusion
• hysterectomy
• patient care team
• placenta accreta