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Table 4 Maternal and neonatal outcomes for women with PAS grade 3 in the UK, France, and Italy

From: Management and outcomes of women with placenta accreta spectrum grade 3: an INOSS multicountry multiperiod population-based study

 

UK

n (%)

n = 39

France n (%)

n = 51

Italy

n (%)

n = 34

P

Maternal outcomes

    

Total EBL (mL) (median, IQR)*

3000 [1500–8000]

1200 [500–2750]

1500 [1000–2000]

-

Min-Max

300-24000

500–9000

700–4500

 

EBL ≥ 1500 mL (%)*

31 (79)

19 (39)

18 (53)

< 0.01

EBL ≥ 3000 mL (%)*

21 (54)

13 (25)

4 (12)

< 0.01

Packed RBCs transfused*

28 (72)

34 (67)

26 (76)

0.62

Number of packed RBCs transfused (median, IQR)*

8 [6–14]

6 [3-10.7]

2.5 [1.3-4]

< 0.01

Packed RBCs transfused ≥ 4

26 (67)

24 (47)

14 (41)

0.06

Platelet units transfused*

13 (33)

8 (16)

1 (3)

< 0.01

Fresh frozen plasma transfused*

20 (41)

29 (57)

7 (21)

< 0.01

Fibrinogen*

 

10 (26)

19 (37)

2 (6)

< 0.01

Recombined activated factor VII*

 

3 (8)

1 (2)

0 (0)

0.14

Tranexamic acid*

 

NA

22 (43)

5 (15)

< 0.01

Use of cell saver

 

8 (31)

7 (14)

1 (3)

0.02

Missing

13

2

0

 

Any uterine suture or pelvic vessel ligation*

11 (28)

8 (16)

4 (12)

0.16

Maternal transfer to ICU*

 

31 (80)

21 (41)

11 (32)

< 0.01

ICU length of stay (days) (median, IQR)*

2[1–3]

2 [1–2]

1[1–2]

0.23

Maternal death*

 

0 (0)

1 (2)

0 (0)

0.49

Post-delivery infection

 

0 (0)

15 (30)

0 (0)

< 0.01

Missing

0

1

0

 

Damage to bowel or urinary tract*

6 (19)

9 (18)

6 (18)

0.95

Neonatal outcomes

     

In utero fetal death*

 

2 (5)

2 (4)

0 (0)

0.56

Among live births

     

Neonatal ICU admission

 

18 (50)

28 (56)

15 (63)

0.38

Missing

1

0

11

 

Neonatal death

1 (3)

0 (0)

1 (3)

0.48

Missing

1

2

0

 
  1. Data are reported as numbers (percentages) unless otherwise stated
  2. EBL: estimated blood loss, ICU: intensive care unit, RBCs: red blood cells, IQR: interquartile, NICU: neonatal intensive care units; NA: not available
  3. *: no missing data for any country
  4. †: B-Lynch or other uterine suture and/or uterine ligation and/or pelvic vessel ligation
  5. ‡: A woman with a body mass index of 41.5 and prenatally suspected placenta accreta had an emergency cesarean hysterectomy at 32 weeks of gestation because of preeclampsia and bleeding, followed by a pelvic arterial embolization because of diffuse bleeding with coagulopathy. After 2 days, she died of multiorgan failure