Predictors of massive blood loss in women with placenta accreta

Objective: We examined predictors of massive blood loss for women with placenta accreta who had undergone hysterectomy. Study Design: A retrospective review of women who underwent peripartum hysterectomy for pathologically confirmed placenta accreta was performed. Characteristics that are associated with massive blood loss (<5000 mL) and large-volume transfusion (<10 units packed red cells) were examined. Results: A total of 77 patients were identified. The median blood loss was 3000 mL, with a median of 5 units of red cells transfused. There was no association among maternal age, gravidity, number of previous deliveries, number of previous cesarean deliveries, degree of placental invasion, or antenatal bleeding and massive blood loss or large-volume transfusion (P > .05). Among women with a known diagnosis of placenta accreta, 41.7% had an estimated blood loss of <5000 mL, compared with 12.0% of those who did not receive the diagnosis antenatally with ultrasound scanning (P = .01). Conclusion: There are few reliable predictors of massive blood loss in women with placenta accreta.