Evaluation of Maternal Hemorrhage in Placenta Accreta

Abstract

Objective: The aim of the present study is to provide a retrospective evaluation of placenta accreta cases to identify the factors affecting the blood transfusion requirement, which stands as one of the most important causes of maternal mortality and morbidity.
study desıgn: A total of 110 patients who presented to the outpatient clinic of gynaecology and obstetrics of the Faculty of Medicine of Dicle University and were diagnosed with placental attachment before or during a caesarean section (C-section) between January 2006 and June 2015 were included in this study. The patients’ data were collected from the hospital’s records.
Results: During the study period, 21674 births were realised and 110 (1/200) of these patients exhibited placenta accreta. 86 of these 110 patients (78,2%) received at least one unit of blood. The group of patients that had received blood transfusion exhibited significantly higher values in age, parity, number of C-sections, length of stay (p = 0.003, 0.004, 0.024, 0.000, respectively). Multiple logistical regression analysis led to the identification of a significant association between the length of stay and the blood transfusion requirements (OR 95% Cl 2.005(1.213-3.314) p= 0.007).
Conclusion: Patients of advanced age as well as grand multiparous patients and patients with a history of multiple repeat caesarean deliveries should be evaluated more carefully during pregnancy. These patients should be referred to hospitals that provide multidisciplinary care and management before the delivery or even at the early stages of pregnancy in an effort to decrease maternal mortality and morbidity rates.