TITLE:
Blood Consumption in Placental Abnormalities
AUTHORS:
Mufareh Asiri, Salem Al Suwaidan, Nawal Al Harbi, Abuobeida Ahmed, Reem Alanazi, Razan Al Harbi, Najla Al Ajmi
KEYWORDS:
Placenta Previa, Placenta Accreta Spectrum (PAS), Hemorrhage, Maternal Mortality, Hysterectomy
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.12 No.10,
October
31,
2022
ABSTRACT: Introduction: Hemorrhage is one of the most common causes of maternal morbidity and
mortality. This study was conducted to investigate how much abnormal
placentation can affect blood bank capacity and to measure the burden on the
blood bank caused by excessive use of blood and blood products. Methodology:
This is a retrospective study conducted at King Saud Medical City Maternity
Hospital in Riyadh, Kingdom of Saudi Arabia, from January 2019-September 2020.
It includes 170 cases diagnosed with abnormal placentation (low-lying placenta
or placenta previa, accreta, increta, or percreta). The primary purpose was to
measure consumption of blood and blood products in cases of placental
abnormalities and to investigate how much this affects blood bank capacity. A
secondary aim was to report rates of admission to the ICU and maternal
mortality. Results: This study included 170 women with placental
abnormalities. Placental previa had occurred in 96 cases, followed by placenta
accreta in 46 cases, placenta increta in 13 cases, placenta percreta in 8 cases, and low-lying
placenta in 7 cases.
Most patients (93) were treated with a Bakri balloon to prevent hemorrhage, but
38 patients had a hysterectomy. The average estimation of blood loss was 2210
ml, with no maternal mortality. An average of 3.39 units of packed red blood
cells (PRBC) with a maximum of 20 units, 2.12 units of fresh frozen plasma
(FFP) with a maximum of 20 units, and 0.7 units of packed platelets (PP) with
maximum of 12 units consumed per patient. Eighty-seven patients (51.2%) were
admitted to the ICU and 83 others (48.8%) were admitted to the high dependency
unit. Conclusion: Blood and blood product volumes had a linear
relationship with the severity of placental abnormalities and estimated blood
loss. Therefore, blood bank services should be available to save mothers’ life.