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:
Collins, S.L., Chantraine, F., Morgan, T.K. and Jauniaux, E. (2018) Abnormally Adherent and Invasive Placenta: A Spectrum Disorder in Need of a Name. Ultrasound in Obstetrics & Gynecology, 51, 165-166. https://doi.org/10.1002/uog.18982
[3]
Oyelese, Y. and Smulian, J.C. (2006) Placenta Previa, Placenta Accreta, and Vasa Previa. Obstetrics & Gynecology, 107, 927-941.
https://doi.org/10.1097/01.AOG.0000207559.15715.98
[4]
Miller, D.A., Chollet, J.A. and Goodwin, T.M. (1997) Clinical Risk Factors for Placenta Previa-Placenta Accreta. American Journal of Obstetrics and Gynecology, 177, 210-214. https://doi.org/10.1016/S0002-9378(97)70463-0
[5]
Wu, S., Kocherginsky, M. and Hibbard, J.U. (2005) Abnormal Placentation: Twenty-Year Analysis. American Journal of Obstetrics and Gynecology, 192, 1458-1461.
https://doi.org/10.1016/j.ajog.2004.12.074
[6]
Ryding, E.L., Lukasse, M., Kristjansdottir, H., Steingrimsdottir, T., Schei, B. and Bidens Study Group (2016) Pregnant Women’s Preference for Cesarean Section and Subsequent Mode of Birth—A Six-Country Cohort Study. Journal of Psychosomatic Obstetrics & Gynecology, 37, 75-83.
https://doi.org/10.1080/0167482X.2016.1181055
[7]
Solheim, K.N., Esakoff, T.F., Little, S.E., Cheng, Y.W., Sparks, T.N. and Caughey, A.B. (2011) The Effect of Cesarean Delivery Rates on the Future Incidence of Placenta Previa, Placenta Accreta, and Maternal Mortality. Journal of Maternal-Fetal and Neonatal Medicine, 24, 1341-1346.
https://doi.org/10.3109/14767058.2011.553695
[8]
Confidential Enquiry into Maternal and Child Health (2004) Why Mother Die 2000-2002. RCOG Press, London.
[9]
Brace, V., Penney, G. and Hall, M. (2004) Quantifying Severe Maternal Morbidity: A Scottish Population Study. BJOG: An International Journal of Obstetrics & Gynaecology, 111, 481-484. https://doi.org/10.1111/j.1471-0528.2004.00101.x
[10]
Pattinson, R.C., Buchmann, E., Mantel, G., Schoon, M. and Rees, H. (2003) Can enquiries into Severe Acute Maternal Morbidity Act as a Surrogate for Maternal Death Enquiries? BJOG: An International Journal of Obstetrics & Gynaecology, 110, 889-893. https://doi.org/10.1111/j.1471-0528.2003.03044.x
[11]
Abduljabbar, H.S., Bahkali, N.M., Al-Basri, S.F., Al Hachim, E., Shoudary, I.H., Dause, W.R., Mira, M.Y. and Khojah, M. (2016) Placenta Previa: A 13 Years Experience at a Tertiary Care Center in Western Saudi Arabia. Saudi Medical Journal, 37, 762-766. https://doi.org/10.15537/smj.2016.7.13259
[12]
Betrán, A.P., Merialdi, M., Lauer, J.A., Bing-Shun, W., Thomas, J., Van Look, P. and Wagner, M. (2007) Rates of Caesarean Section: Analysis of Global, Regional and National Estimates. Paediatric and Perinatal Epidemiology, 21, 98-113.
https://doi.org/10.1111/j.1365-3016.2007.00786.x
[13]
Ahmed, A.E. and Mohammad, R.S. (2018) Cesarean Sections. Associated Factors and Frequency at King Abdulaziz Medical City in the Central Region of the Kingdom of Saudi Arabia. Saudi Medical Journal, 39, 1154-1157.
https://doi.org/10.15537/smj.2018.11.22499
[14]
Blackwell, S.C. (2011) Timing of Delivery for Women with Stable Placenta Previa. Seminars in Perinatology, 35, 249-251.
https://doi.org/10.1053/j.semperi.2011.05.004
[15]
Räisänen, S., Kancherla, V., Kramer, M.R., Gissler, M. and Heinonen, S. (2014) Placenta Previa and the Risk of Delivering a Small-for-Gestational-Age Newborn. Obstetrics and Gynecology, 124, 285-291.
https://doi.org/10.1097/AOG.0000000000000368
[16]
Kwon, H.Y., Kim, Y.H., Park, Y.W. and Kwon, J.Y. (2016) Efficacy of Bakri Balloon Tamponade in Massive Postpartum Hemorrhage: A Series of 57 Cases. Perinatology, 27, 236-243. https://doi.org/10.14734/PN.2016.27.4.236
[17]
Akintayo, A.A., Olagbuji, B.N., Aderoba, A.K., Akadiri, O., Olofinbiyi, B.A. and Bakare, B. (2016) Emergency Peripartum Hysterectomy: A Multicenter Study of Incidence, Indications and Outcomes in Southwestern Nigeria. Maternal and Child Health Journal, 20, 1230-1236. https://doi.org/10.1007/s10995-016-1924-1
[18]
Walker, M.G., Allen, L., Windrim, R.C., Kachura, J., Pollard, L., Pantazi, S., Keating, S., Carvalho, J.C. and Kingdom, J.C. (2013) Multidisciplinary Management of Invasive Placenta Previa. Journal of Obstetrics and Gynaecology Canada, 35, 417-425.
https://doi.org/10.1016/S1701-2163(15)30932-4
[19]
Parva, M., Chamchad, D., Keegan, J., Gerson, A. and Horrow, J. (2010) Placenta Percreta with Invasion of the Bladder Wall: Management with a Multi-Disciplinary Approach. Journal of Clinical Anesthesia, 22, 209-212.
https://doi.org/10.1016/j.jclinane.2009.03.018
[20]
Angstmann, T., Gard, G., Harrington, T., Ward, E., Thomson, A. and Giles, W. (2010) Surgical Management of Placenta Accreta: A Cohort Series and Suggested Approach. American Journal of Obstetrics and Gynecology, 202, 38-e1.
https://doi.org/10.1016/j.ajog.2009.08.037
[21]
Engelsen, I.B., Albrechtsen, S. and Iversen, O.E. (2001) Peripartum Hysterectomy-Incidence and Maternal Morbidity. Acta Obstetricia et Gynecologica Scandinavica, 80, 409-412. https://doi.org/10.1034/j.1600-0412.2001.080005409.x
[22]
Gardeil, F., Daly, S. and Turner, M.J. (1995) Peripartum Hysterectomy: Report of Eleven Cases. Revue francaise de gynecologie et d’obstetrique, 90, 431-434.
[23]
Bakshi, S. and Meyer, B.A. (2000) Indications for and Outcomes of Emergency Peripartum Hysterectomy: A Five-Year Review. Journal of Reproductive Medicine for the Obstetrician and Gynecologist, 45, 733-737.
[24]
Machado, L.S. (2011) Emergency Peripartum Hysterectomy: Incidence, Indications, Risk Factors and Outcome. North American Journal of Medical Sciences, 3, 358-361. https://doi.org/10.4297/najms.2011.358
[25]
Zamzami, T.Y. (2003) Indication of Emergency Peripartum Hysterectomy: Review of 17 Cases. Archives of Gynecology and Obstetrics, 268, 131-135.
https://doi.org/10.1007/s00404-003-0494-9
[26]
Bao, Y., Xu, C., Qu, X., Quan, S., Dong, Y. and Ying, H. (2016) Risk Factors for Transfusion in Cesarean Section Deliveries at a Tertiary Hospital. Transfusion, 56, 2062-2068. https://doi.org/10.1111/trf.13671
[27]
Vlaar, A.P., Schultz, M.J. and Juffermans, N.P. (2009) Transfusion-Related Acute Lung Injury: A Change of Perspective. The Netherlands Journal of Medicine, 67, 320-326.
[28]
Vlaar, A.P., Hofstra, J.J., Determann, R.M., Veelo, D.P., Paulus, F., Kulik, W., Korevaar, J., de Mol, B.A., Koopman, M.M., Porcelijn, L. and Binnekade, J.M. (2011) The Incidence, Risk Factors, and Outcome of Transfusion-Related Acute Lung Injury in a Cohort of Cardiac Surgery Patients: A Prospective Nested Case-Control Study. Blood: The Journal of the American Society of Hematology, 117, 4218-4225.
https://doi.org/10.1182/blood-2010-10-313973
[29]
Gajic, O., Rana, R., Winters, J.L., Yilmaz, M., Mendez, J.L., Rickman, O.B., O’Byrne, M.M., Evenson, L.K., Malinchoc, M., DeGoey, S.R. and Afessa, B. (2007) Transfusion-Related Acute Lung Injury in the Critically Ill: Prospective Nested Case-Control Study. American Journal of Respiratory and Critical Care Medicine, 176, 886-891. https://doi.org/10.1164/rccm.200702-271OC
