Early Detection and Good Team Collaboration for Preventing Maternal Death Caused by Placenta Accreta Spectrum Disorder

Eric Edwin Yuliantara, Muhammad Adrianes Bachnas, Nutria Widya Purna Anggraini, Wisnu Prabowo, Gagah Baskara Adi Nugraha, Meriska Dewi Chasanah, Fadel Muhammad S. Alim, Hikmah F. Merina

Abstract


Background: Placenta accreta spectrum (PAS) is considered one of the most harmful pregnancy conditions, as it is strongly linked with maternal morbidity and mortality. An accurate and early prenatal diagnosis of PAS allows time for a multidisciplinary team to plan the best course of action for delivery management. The aim of this study is to describe placenta accreta spectrum management and outcomes with early detection and a multidisciplinary team approach.

Method: A retrospective cohort study was conducted on 167 cases of placenta accreta from 2016 to 2021. Medical records were then reviewed, and data were collected for delivery management and maternal outcome, including estimated amounts of bleeding, urinary tract injury, delivery time, ICU referral, and maternal death.

Result: Delivery management (hysterectomy and conservative management) and maternal bleeding were significantly associated with MAP score (p < 0.05), while urinary tract injury, delivery time, ICU admission, and maternal death were not significantly associated (p > 0.05). 55.1% of patients underwent hysterectomy, and the rest 44.9% underwent conservative surgery. Massive bleeding of more than 2500 mL happened in 54.5% of patients, and the rest 45.5% managed to bleed less than 45.5%. Preterm deliveries accounted for 29.9% of all deliveries, with the remaining 70.1% being term. 5.4% of patients experienced urinary tract injuries. 6.6% of patients were referred to the intensive care unit. The maternal mortality rate is 4.8%.

Conclusion: Early detection of the placenta accreta spectrum, as well as good collaboration among members of a multidisciplinary team from various medical fields, are required to ensure the mother and baby's safety and survival.


Keywords


placenta accreta spectrum; early detection; multidisciplinary team; maternal death

Full Text:

PDF
rticle

References


  1. Yuliantara EE, Anggraini NWP, Prisasanti DP. Massive Adherent Placenta, Placenta Percreta. J Matern Child Heal. 2021;6(1):108–21. doi:10.26911/thejmch.2021.06.01.11
  2. Hobson SR, Kingdom JC, Murji A, Windrim RC, Carvalho JCA, Singh SS, et al. No. 383-Screening, Diagnosis, and Management of Placenta Accreta Spectrum Disorders. J Obstet Gynaecol Canada. 2019;41(7):1035–49. doi:10.1016/j.jogc.2018.12.004
  3. Fitzpatrick KE, Sellers S, Spark P, Kurinczuk JJ, Brocklehurst P, Knight M. The management and outcomes of placenta accreta, increta, and percreta in the UK: A population-based descriptive study. BJOG An Int J Obstet Gynaecol. 2014;121(1):62–71. doi:10.1111/1471-0528.12405
  4. Baldwin HJ, Patterson JA, Nippita TA, Torvaldsen S, Ibiebele I, Simpson JM, et al. Maternal and neonatal outcomes following abnormally invasive placenta: a population-based record linkage study. Acta Obstet Gynecol Scand. 2017;96(11):1373–81. doi:10.1111/aogs.13201
  5. Aryananda RA. Resurgence of placenta accreta in Indonesia. Maj Obstet Ginekol. 2018;26(3):98–9. doi:10.20473/mog.V26I32018.98-99
  6. Yu FNY, Leung KY. Antenatal diagnosis of placenta accreta spectrum (PAS) disorders. Best Pract Res Clin Obstet Gynaecol. 2021;72(xxxx):13–24. doi:10.1016/j.bpobgyn.2020.06.010
  7. Cahill AG, Beigi R, Heine RP, Silver RM, Wax JR. Placenta Accreta Spectrum. Am J Obstet Gynecol. 2018;219(6):B2–16. doi:10.1016/j.ajog.2018.09.042
  8. Liu X, Wang Y, Wu Y, Zeng J, Yuan X, Tong C, et al. What we know about placenta accreta spectrum (PAS). Eur J Obstet Gynecol Reprod Biol. 2021;259(1):81–9. doi:10.1016/j.ejogrb.2021.02.001
  9. Allen L, Jauniaux E, Hobson S, Papillon-Smith J, Belfort MA, Duncombe G, et al. Obstetric Care Consensus No. 7: Placenta Accreta Spectrum. Obstet Gynecol. 2018;132(6):E259–75. doi:10.1097/AOG.0000000000002983
  10. Nieto-Calvache AJ, Palacios-Jaraquemada JM, Osanan G, Cortes-Charry R, Aryananda RA, Bangal VB, et al. Lack of experience is a main cause of maternal death in placenta accreta spectrum patients. Acta Obstet Gynecol Scand. 2021;100(8):1445–53. doi:10.1111/aogs.14163
  11. Bartels HC, Postle JD, Downey P, Brennan DJ. Placenta accreta spectrum: A review of pathology, molecular biology, and biomarkers. Dis Markers. 2018;2018. doi:10.1155/2018/1507674
  12. Aggarwal R, Suneja A, Vaid NB, Yadav P, Sharma A, Mishra K. Morbidly adherent placenta: A critical review [Internet]. J. Obstet. Gynecol. India2012;62(1):57–61. doi:10.1007/s13224-012-0149-5
  13. Bluth A, Schindelhauer A, Nitzsche K, Wimberger P, Birdir C. Placenta accreta spectrum disorders—experience of management in a German tertiary perinatal centre. Arch Gynecol Obstet. 2021;303(6):1451–60. doi:10.1007/s00404-020-05875-x
  14. James AH, Lockhart E. Blood Management for Patients with Placenta Accreta. In: Placenta Accreta Syndrome. Boca Raton, FL: CRC Press; 2017. page 123–36.doi:10.1201/9781315117386-10
  15. Fonseca A, Ayres de Campos D. Maternal morbidity and mortality due to placenta accreta spectrum disorders. Best Pract Res Clin Obstet Gynaecol. 2021;72:84–91. doi:10.1016/J.BPOBGYN.2020.07.011
  16. Shamshirsaz AA, Fox KA, Erfani H, Clark SL, Salmanian B, Baker BW, et al. Multidisciplinary team learning in the management of the morbidly adherent placenta: outcome improvements over time. Am J Obstet Gynecol. 2017;216(6):612.e1-612.e5. doi:10.1016/j.ajog.2017.02.016
  17. Eller AG, Bennett MA, Sharshiner M, Masheter C, Soisson AP, Dodson M, et al. Maternal morbidity in cases of placenta accreta managed by a multidisciplinary care team compared with standard obstetric care. Obstet Gynecol. 2011;117(2):331–7. doi:10.1097/AOG.0b013e3182051db2
  18. Kandil MAS, Sayyed TM, Salah A, Gilany NMA Al. Maternal and neonatal outcomes of placenta accreta: a descriptive case series study. Menoufia Med J. 2019;32(1):212–6. doi:10.4103/mmj.mmj
  19. Palacios-Jaraquemada JM, D’Antonio F, Buca D, Fiorillo A, Larraza P. Systematic review on near miss cases of placenta accreta spectrum disorders: correlation with invasion topography, prenatal imaging, and surgical outcome. J Matern Neonatal Med. 2019;0(0):3377–84. doi:10.1080/14767058.2019.1570494
  20. Nieto-Calvache AJ, Palacios-Jaraquemada JM, Vergara-Galliadi LM, Matera L, Sanín-Blair JE, Rivera EP, et al. All maternal deaths related to placenta accreta spectrum are preventable: a difficult-to-tell reality. AJOG Glob Reports. 2021;1(3):1–9. doi:10.1016/j.xagr.2021.100012
  21. Collins SL, Alemdar B, van Beekhuizen HJ, Bertholdt C, Braun T, Calda P, et al. Evidence-based guidelines for the management of abnormally invasive placenta: recommendations from the International Society for Abnormally Invasive Placenta. Am J Obstet Gynecol. 2019;220(6):511–26. doi:10.1016/j.ajog.2019.02.054
  22. Yasin N, Slade L, Atkinson E, Kennedy-Andrews S, Scroggs S, Grivell R. The multidisciplinary management of placenta accreta spectrum (PAS) within a single tertiary centre: A ten-year experience. Aust New Zeal J Obstet Gynaecol. 2019;59(4):550–4. doi:10.1111/ajo.12932
  23. Einerson BD, Silver RM. Multidisciplinary Teams in the Management of Placenta Accreta Spectrum Disorders. Curr Obstet Gynecol Rep. 2019;8(3):80–5. doi:10.1007/s13669-019-00264-x
  24. Walker MG, Allen L, Windrim RC, Kachura J, Pollard L, Pantazi S, et al. Multidisciplinary Management of Invasive Placenta Previa. J Obstet Gynaecol Canada. 2013;35(5):417–25. doi:10.1016/S1701-2163(15)30932-4
  25. Silver RM, Fox KA, Barton JR, Abuhamad AZ, Simhan H, Huls CK, et al. Center of excellence for placenta accreta. Am J Obstet Gynecol. 2015;212(5):561–8. doi:10.1016/j.ajog.2014.11.018
  26. Mitric C, Desilets J, Balayla J, Ziegler C. Surgical Management of the Placenta Accreta Spectrum: An Institutional Experience. J Obstet Gynaecol Canada. 2019;41(11):1551–7. doi:10.1016/j.jogc.2019.01.016
  27. Lubis MP, Yaznil MR, Barus MNG, Asroel EM, Faustine M. Maternal Outcomes of Hysterectomy and Conservative Surgery in Placenta Accreta. Curr Womens Heal Rev. 2020;16(3):201–5. doi:10.2174/1573404816666200303123850
  28. Yeni CM, Handayani H, Nasir A, Ima Indirayani, Razali R. The Association betweeen Cesarean Section and Placenta Accreta. Indones J Obstet Gynecol. 2022;10(3):127–32. doi:10.32771/inajog.v10i3.1572
  29. Jauniaux E, Bunce C, Grønbeck L, Langhoff-Roos J. Prevalence and main outcomes of placenta accreta spectrum: a systematic review and meta-analysis. Am J Obstet Gynecol. 2019;221(3):208–18. doi:10.1016/j.ajog.2019.01.233
  30. Tovbin J, Melcer Y, Shor S, Pekar-Zlotin M, Mendlovic S, Svirsky R, et al. Prediction of morbidly adherent placenta using a scoring system. Ultrasound Obstet Gynecol. 2016;48(4):504–10. doi:10.1002/uog.15813
  31. Coutinho CM, Giorgione V, Noel L, Liu B, Chandraharan E, Pryce J, et al. Effectiveness of contingent screening for placenta accreta spectrum disorders based on persistent low-lying placenta and previous uterine surgery. Ultrasound Obstet Gynecol. 2021;57(1):91–6. doi:10.1002/uog.23100
  32. D’Antonio F, Iacovella C, Bhide A. Prenatal identification of invasive placentation using ultrasound: Systematic review and meta-analysis. Ultrasound Obstet Gynecol. 2013;42(5):509–17. doi:10.1002/uog.13194
  33. Alsadah A, Al hassani A, Moretti F. 568: Validation of a scoring system for prediction of morbidly adherent placenta in high risk population. Am J Obstet Gynecol. 2020;222(1):S364–5. doi:10.1016/j.ajog.2019.11.584
  34. Ali AENAEG, Mohammad AA, Khodry MM, Abdallah KM, Abbas AM. Predictive values of ultrasound-based scoring system in morbidly adherent placenta for high risk group. Int J Reprod Contraception, Obstet Gynecol. 2018;7(11):4426. doi:10.18203/2320-1770.ijrcog20184484
  35. Jauniaux E, Bhide A. Prenatal ultrasound diagnosis and outcome of placenta previa accreta after cesarean delivery: a systematic review and meta-analysis. Am J Obstet Gynecol. 2017;217(1):27–36. doi:10.1016/j.ajog.2017.02.050
  36. Jauniaux E, Bhide A, Kennedy A, Woodward P, Hubinont C, Collins S, et al. FIGO consensus guidelines on placenta accreta spectrum disorders: Prenatal diagnosis and screening. Int J Gynecol Obstet. 2018;140(3):274–80. doi:10.1002/ijgo.12408
  37. Alves ÁLL, Silva LB da, Costa F da S, Rezende G de C. Management of placenta accreta spectrum. Rev Bras Ginecol e Obs / RBGO Gynecol Obstet. 2021;43(09):713–23. doi:10.1055/s-0041-1736371
  38. Tikkanen M, Paavonen J, Loukovaara M, Stefanovic V. Antenatal diagnosis of placenta accreta leads to reduced blood loss. Acta Obstet Gynecol Scand. 2011;90(10):1140–6. doi:10.1111/j.1600-0412.2011.01147.x
  39. Warshak CR, Ramos GA, Eskander R, Benirschke K, Saenz CC, Kelly TF, et al. Effect of predelivery diagnosis in 99 consecutive cases of placenta accreta. Obstet Gynecol. 2010;115(1):65–9. doi:10.1097/AOG.0b013e3181c4f12a
  40. Sentilhes L, Kayem G, Chandraharan E, Palacios-Jaraquemada J, Jauniaux E, Duncombe G, et al. FIGO consensus guidelines on placenta accreta spectrum disorders: Conservative management. Int J Gynecol Obstet. 2018;140(3):291–8. doi:10.1002/ijgo.12410
  41. Wang Q, Ma J, Zhang H, Dou R, Huang B, Wang X, et al. Conservative management versus cesarean hysterectomy in patients with placenta increta or percreta. J Matern Neonatal Med. 2022;35(10):1944–50. doi:10.1080/14767058.2020.1774871
  42. Setyawan N, Permana S. Massive transfusion in cesarean section patients with placenta accreta: A case series. Bali J Anesthesiol. 2021;5(3):191–4. doi:10.4103/bjoa.bjoa_221_20
  43. Chen L, Wang X, Wang H, Li Q, Shan N, Qi H. Clinical evaluation of prophylactic abdominal aortic balloon occlusion in patients with placenta accreta: A systematic review and meta-analysis. BMC Pregnancy Childbirth. 2019;19(1):1–8. doi:10.1186/s12884-019-2175-0
  44. Lu R, Chu R, Wang Q, Xu Y, Zhao Y, Tao G, et al. Role of Abdominal Aortic Balloon Placement in Planned Conservative Management of Placenta Previa With Placenta Increta or Percreta. Front Med. 2021;8(December):1–9. doi:10.3389/fmed.2021.767748
  45. Wright JD, Pri-Paz S, Herzog TJ, Shah M, Bonanno C, Lewin SN, et al. Predictors of massive blood loss in women with placenta accreta. Am J Obstet Gynecol. 2011;205(1):38.e1-38.e6. doi:10.1016/j.ajog.2011.01.040
  46. Norris BL, Everaerts W, Posma E, Murphy DG, Umstad MP, Costello AJ, et al. The urologist’s role in multidisciplinary management of placenta percreta. BJU Int. 2016;117(6):961–5. doi:10.1111/bju.13332
  47. Ng MK, Jack GS, Bolton DM, Lawrentschuk N. Placenta Percreta With Urinary Tract Involvement: The Case for a Multidisciplinary Approach. Urology. 2009;74(4):778–82. doi:10.1016/j.urology.2009.01.071
  48. Kelly BD, Moorhead R, Wetherell D, Gilchrist T, Furrer M, Perera M, et al. Urological Involvement in the Multidisciplinary Management of Placenta Accreta Spectrum in a Centralised, High-Volume Centre: A Retrospective Analysis. Société Int d’Urologie J. 2022;3(1):28–32. doi:10.48083/olra4694
  49. Mohammed MA, Al-Boghdady AA, Ibraheem IS. Incidence of Placenta Accreta and Its Complications in Cases of Previous Cesearean Sections with Placenta Praevia Anterior at El-Sayed Galal Hospital. Egypt J Hosp Med. 2018;73(8):7334–42. doi:10.21608/ejhm.2018.18466
  50. Friedrich L, Mor N, Weissmann‐Brenner A, Kassif E, Friedrich SN, Weissbach T, et al. Risk factors for bladder injury during placenta accreta spectrum surgery. Int J Gynecol Obstet. 2022;doi:10.1002/ijgo.14567
  51. Ornaghi S, Maraschini A, Donati S, Donati S, Maraschini A, D’Aloja P, et al. Characteristics and outcomes of pregnant women with placenta accreta spectrum in Italy: A prospective population-based cohort study. PLoS One. 2021;16(6 June):1–16. doi:10.1371/journal.pone.0252654
  52. Salmanian B, Einerson BD, Carusi DA, Shainker SA, Nieto-Calvache AJ, Shrivastava VK, et al. Timing of delivery for placenta accreta spectrum: the Pan-American Society for the Placenta Accreta Spectrum experience. Am J Obstet Gynecol MFM. 2022;4(6):100718. doi:10.1016/j.ajogmf.2022.100718
  53. Perlman NC, Little SE, Thomas A, Cantonwine DE, Carusi DA. Patient selection for later delivery timing with suspected previa-accreta. Acta Obstet Gynecol Scand. 2017;96(8):1021–8. doi:10.1111/aogs.13140
  54. Balayla J, Bondarenko HD. Placenta accreta and the risk of adverse maternal and neonatal outcomes. J Perinat Med. 2013;41(2):141–9. doi:10.1515/jpm-2012-0219




DOI: https://doi.org/10.20961/placentum.v11i2.71047

Refbacks

  • There are currently no refbacks.


Copyright (c) 2023 PLACENTUM: Jurnal Ilmiah Kesehatan dan Aplikasinya

View My Stats

Lisensi Creative Commons
This work is licensed under a Creative Commons Attribution-ShareAlike International 4.0 (CC BY-SA 4.0).