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Placenta accreta spectrum (PAS) is a group of placental invasion pathologies associated with significant morbidity to both mother and fetus. The majority of patients with PAS will require a blood transfusion at time of delivery and subsequent cesarean hysterectomy. The optimal approach to maternal acute blood loss resuscitation is currently unknown. Here, we present a cohort analysis of 34 patients with pathology-confirmed PAS treated with either whole blood ( n  = 16) or component therapy ( n  = 18) for initial intraoperative resuscitation. We observed comparable results in post-operative outcomes with fewer overall transfusions and subsequently, lower volumes of resuscitation ( p =.03) with whole blood initial resuscitation. Whole blood transfusion may represent a viable option for initial resuscitation with lower resuscitation volumes and transfusion-associated complications without directly effecting post-operative outcomes in cases of PAS.

Whole blood transfusion reduces overall component transfusion in cases of placenta accreta spectrum: a pilot program