Risk of Severe Maternal Morbidity in Patients with Placenta Accreta Spectrum Disorders Referred from Rural…

Cohort studyAmerican journal of perinatology· Dec 2023

Risk of Severe Maternal Morbidity in Patients with Placenta Accreta Spectrum Disorders Referred from Rural Communities to a Regional Placenta Accreta Spectrum Center.

Jessian L Munoz, Patrick S Ramsey, John J Byrne

Transfusion MedicineCohort studyQ2IF 1.6

Rural patients with placenta accreta spectrum had higher severe maternal morbidity, 28.9% vs 12.8%

Risk of Severe Maternal Morbidity in Patients with Placenta Accreta Spectrum Disorders Referred from Rural Communities to a Regional Placenta Accreta Spectrum Center.

Jessian L Munoz … John J Byrne

American journal of perinatology · Dec 2023

Purpose

Subsequently, we aimed to determine a distance-dependent relationship between placenta accreta spectrum morbidity and distance travelled by patients in rural communities.

Methods

This was a retrospective cohort study of patients who had placenta accreta spectrum histopathological confirmation and delivery at our institution from 2005 to 2022.

n = 139 patients

Results

rural patients had more than double the risk of severe maternal morbidity

Rural

28.9%

Urban

12.8%

More results

During the study period, 139 patients were managed by cesarean hysterectomy with confirmed placenta accreta spectrum histopathology.

Of these, 94 (67.6%) were from our urban community and 45 (32.4%) were from surrounding rural communities.

More results

The overall severe maternal morbidity incidence was 85% including blood transfusion and 17% without blood transfusions.

Severe maternal morbidity did reveal a distance-dependent relationship with severe maternal morbidity rates of 13.2, 33.3, and 43.8% at 50, 100, and 150 miles, respectively ( p = 0.005).

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Conclusion · 1 of 3

Patients with placenta accreta spectrum experience high rates of severe maternal morbidity. Geographic distance to a placenta accreta spectrum center appears to significantly impact the overall morbidity a patient experiences.

Conclusion · 2 of 3

Further research is warranted to address this disparity and optimize patient outcomes for patients in rural communities KEY POINTS: · Patients from rural communities experience greater severe maternal morbidity in the setting of placenta accreta spectrum..

Conclusion · 3 of 3

· Intraoperative outcomes and interventions were similar, regardless of patient location..