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.
Keywords
morbidly adherent placenta - cesarean hysterectomy - placenta accreta
