CC-BY-NC-ND 4.0 · AJP Rep 2017; 07(04): e211-e214
DOI: 10.1055/s-0037-1608641
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Treatment of Morbidly Adherent Placentation Utilizing a Standardized Multidisciplinary Approach in the Community Hospital–Private Practice Setting

Mahsa Mansouri
1  Austin Maternal-Fetal Medicine, Austin, Texas
,
Kim DeStefano
1  Austin Maternal-Fetal Medicine, Austin, Texas
2  St. David's Women's Center of Texas, Austin, Texas
,
Brian Monks
2  St. David's Women's Center of Texas, Austin, Texas
3  OB Hospitalist Group, Mauldin, South Carolina
,
Jasbir Singh
1  Austin Maternal-Fetal Medicine, Austin, Texas
2  St. David's Women's Center of Texas, Austin, Texas
,
Mollie McDonnold
1  Austin Maternal-Fetal Medicine, Austin, Texas
2  St. David's Women's Center of Texas, Austin, Texas
,
Jamison Morgan
2  St. David's Women's Center of Texas, Austin, Texas
3  OB Hospitalist Group, Mauldin, South Carolina
,
Richard Hale
1  Austin Maternal-Fetal Medicine, Austin, Texas
2  St. David's Women's Center of Texas, Austin, Texas
,
Jasvant Adusumalli
1  Austin Maternal-Fetal Medicine, Austin, Texas
2  St. David's Women's Center of Texas, Austin, Texas
,
Amanda Horton
1  Austin Maternal-Fetal Medicine, Austin, Texas
2  St. David's Women's Center of Texas, Austin, Texas
,
Sina Haeri
1  Austin Maternal-Fetal Medicine, Austin, Texas
2  St. David's Women's Center of Texas, Austin, Texas
› Author Affiliations
Further Information

Publication History

12 May 2017

26 September 2017

Publication Date:
22 November 2017 (online)

Abstract

Objective Morbidly adherent placentation is associated with increased maternal morbidity and mortality. Recently, there has been mounting evidence supporting the benefits of a standardized multidisciplinary approach at tertiary teaching hospitals. Our objective was to estimate the impact of the implementation of a similar program at a high-volume private community hospital.

Study Design In this retrospective cohort study, we evaluated maternal outcomes in all cases of histopathologically confirmed morbidly adherent placentation since the initiation of our multidisciplinary program (2012–2016). Our data were compared with the previously published outcomes of two large cohorts from tertiary teaching hospitals in Utah and Texas.

Results In the 28 cases included for evaluation, our group's median estimated blood loss, median packed red blood cells transfused, median anesthesia time, median length of stay, or rates of maternal morbidity did not statistically differ from the published data in Utah or Texas.

Conclusion Our data demonstrate the feasibility and utility of a multidisciplinary morbidly adherent placentation program in the private practice/community hospital setting with outcomes similar to those at tertiary teaching hospitals. Implementation of such program may prove beneficial in remote centers, where various factors may prohibit patient travel to a larger center.

Funding

None.