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Poster Session 2

Category: Clinical Obstetrics

Poster Session 2

(405) Does Transfusion Differ in Placenta Accreta Spectrum Compared to Postpartum Hemorrhage Secondary to Other Causes

Wednesday, February 11, 2026

3:30 PM - 5:00 PM

Submitting Author and Presenting Author(s)

Alesha M. White, MD (she/her/hers)

Maternal Fetal Medicine Fellow
University of Texas Southwestern Medical Center
Grand Prairie, Texas, United States

Coauthor(s)

JP

Jessica E. Pruszynski, PhD

University of Texas Southwestern Medical Center
Dallas, Texas, United States
Anne M. Ambia, MD

Assistant Professor
University of Texas Southwestern Medical Center
Dallas, Texas, United States
Catherine Y. Spong, MD

Professor and Chair
University of Texas Southwestern Medical Center
Dallas, Texas, United States
Christina L. Herrera, MD

Assistant Professor
University of Texas Southwestern Medical Center
Dallas, Texas, United States

Objective:
The objective of this study is to compare transfusion requirements between patients with placenta accreta spectrum (PAS) who undergo scheduled cesarean delivery (CD) with or without hysterectomy to patients who undergo scheduled CD and experienced PPH.

Study Design:
This is a retrospective cohort study of patients with clinical diagnosis of PAS based on FIGO classification who delivered at a single institution with a multidisciplinary team between 2019 to 2025. Maternal demographics and delivery characteristics were compared between patients with PAS who underwent scheduled delivery to patients who underwent scheduled CD for other reasons but experienced PPH with an EBL of 1500cc or greater.

Results:
Of 564 patients, 68 had PAS and 496 did not. Patients who underwent delivery for PAS delivered at earlier gestational ages (36 (36-36) vs 39 (38-39), p< 0.001) and were more likely to undergo hysterectomy (93% vs 4%, p< 0.001) with higher median EBLs (2000 (1500-2500cc) vs 1500 (1500-1750cc), p</span><0.001). They were more likely to receive a transfusion (79% vs 30%, p< 0.001) and to receive packed red blood cells (pRBCs) (RR 2.76 (95% CI 2.23-3.33)) and fresh frozen plasma (FFP) (RR 5.97 (95% CI 4.13-8.48)). Rates of massive transfusion were also higher (26% vs 2%, p< 0.001) (Table 1). Of those transfused, PAS patients received a higher median number of total products (4.5 (1-55) vs 2 (1-34), p< 0.001) with higher median packed red blood cells and FFP transfused (both p< 0.001). Timing of transfusion also differed with immediate transfusion (0-2 hours from delivery) more common in the PAS cohort (p< 0.001).

Conclusion:
Transfusion requirements are higher in patients with PAS than those who experience PPH after cesarean. The type of product required was significantly different with an increased use of FFP in cases of PAS. In preoperative planning for cases of PAS, blood products to include pRBCs and FFP should be readily available.