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CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
Recording available 2/16-5/2
Recording available 2/16-5/2
AIUM Credit
AIUM Credit
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Foundation Awardee
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Abstract Award
Abstract Award
Foundation Awardee
Foundation Awardee

Poster Session 4

Category: Obstetric Quality and Safety

Poster Session 4

(1003) Transfusion Requirements by Acuity for Prenatally Suspected Placenta Accreta Spectrum

Thursday, February 12, 2026
3:30 PM - 5:00 PM  
Objective:
Morbidity associated with placenta accreta spectrum (PAS) is reduced with prenatal diagnosis and multidisciplinary management. Transfusion is a known complication of PAS, but there is limited data on transfusion requirements based on acuity of delivery. The objective of this study is to compare transfusion needs based on acuity of delivery.

Study Design:
This is a retrospective cohort study that included all patients with prenatally suspected PAS at a single institution with a multidisciplinary team between 2019 and 2025. Maternal demographics and transfusion characteristics were compared between patients with prenatally suspected PAS who underwent scheduled delivery to those who developed another earlier indication for delivery. A multidisciplinary PAS team was involved in the coordination of delivery, regardless of acuity. Patients diagnosed with PAS intraoperatively without prior concern were excluded. 

Results:

Of 169 cases of prenatally suspected PAS, 114 (67%) were scheduled. As anticipated, patients with acute indication delivered at earlier gestational ages (34 (30.5-35.5) vs 36 (36-36), p< 0.001) and were more likely to have a diagnosis of gestational hypertension (p=0.025) or pre-eclampsia with severe features (p< 0.001). Twenty-four (44%) of these patients were delivered for vaginal bleeding. Degree of PAS based on pathology, hysterectomy rates, and estimated blood loss were not different between groups (Table 1). Although rate of transfusion and activation of massive transfusion protocol did not differ, deliveries with acute indication were more likely to receive a transfusion of platelets (16% vs 3%, p=0.002). Total number of units (4 (1-55) vs 5 (1-33), p=0.499) and timing of transfusion did not significantly differ (Table 2).

Conclusion:
Early indicated delivery accounted for a third of prenatally suspected PAS cases. While receiving platelets at a higher rate to compensate for hemorrhage and lost clotting factors, overall transfusion characteristics based on acuity of delivery do not significantly differ.