National Maternity Hospital, Holles Street, Dublin 2, Ireland.
Department of Surgery, Mater Misericordiae University Hospital, Dublin, 7, Ireland.
Ir J Med Sci. 2021 Nov;190(4):1451-1457. doi: 10.1007/s11845-020-02473-3. Epub 2021 Jan 15.
The purpose of this study is to compare maternal outcomes in patients with placenta accreta spectrum (PAS) when managed as part of a multi-disciplinary team (MDT) compared to standard care.
Patients in the standard care group were retrospectively identified from pathology records, with patients in the MDT group prospectively collected on an electronic database. Data on maternal demographics, delivery, estimated blood loss (EBL), transfusion requirements, and morbidity were recorded.
Sixty patients were diagnosed with PAS between 2006 and 2019, of whom 32 were part of the standard care group and 28 in the MDT group. Compared to standard care, MDT care was associated with an increase in antenatal diagnosis from 56.3 to 92.9% (p < 0.0001), a significant reduction in EBL (4150 mL (800-19500) vs 1975 (495-8500), p < 0.0001), and transfusion requirements (median 7 (0-30) units of RCC vs 1 (0-13), p < 0.0001).
PAS is associated with significant maternal morbidity and warrants management in an MDT setting with specialist input, which is associated with improved outcomes.
本研究旨在比较胎盘植入谱系疾病（PAS）患者在多学科团队（MDT）管理与标准治疗下的母婴结局。
从病理记录中回顾性确定标准治疗组患者，前瞻性地将 MDT 组患者纳入电子数据库。记录产妇人口统计学、分娩、估计失血量（EBL）、输血需求和发病率的数据。
2006 年至 2019 年期间诊断出 60 例 PAS 患者，其中 32 例为标准治疗组，28 例为 MDT 组。与标准治疗相比，MDT 治疗与产前诊断率从 56.3%增加到 92.9%（p < 0.0001）、EBL 显著减少（4150 毫升（800-19500）与 1975 毫升（495-8500），p < 0.0001）和输血需求（中位数 7（0-30）个 RCC 单位与 1（0-13）个，p < 0.0001）。
PAS 与显著的产妇发病率有关，需要在 MDT 环境中进行管理，有专科医生的参与，可改善结局。
