Placenta accreta: How our multidisciplinary team saves lives


2k14-0024-AK1_9489 Dr Alireza Shamshirsaz

Morbidly adherent placenta (MAP) is a serious complication during pregnancy that can cause mortality and severe morbidity. MAP occurs when a women’s placenta grows deeply into the wall of her uterus and is unable to detach after childbirth.

Depending on the depth of the invasion, it is known as placenta accreta, increta or percreta.

Over the years, we have learned our outcomes for these patients at Texas Children’s Pavilion for Women has improved over time as our experience within a well-established multidisciplinary team increased. Performing two to three cases per month, along with small collective changes in our team’s dynamics, led to continuous improvement of our clinical outcomes for these women.

Since being established in 2011, our multidisciplinary team approach led to a significant decrease in maternal morbidity for patients with placenta accreta at our hospital. We believe as our multidisciplinary team sees more cases and the techniques used to treat these conditions continues to improve, we are hopeful to see even greater decreases in maternal morbidity associated with MAP. Our team sees a high volume of patients who have placenta accreta, treating more than 200 patients over the past five years.

The multidisciplinary team that cares for these patients is comprised of experts from a number of medical subspecialties including, maternal-fetal medicine, radiology, obstetric anesthesiology, pulmonary critical care, transfusion medicine, urology and neonatology. Other subspecialties we consult with on an as-needed basis are gynecologic oncology, vascular surgery and interventional radiology. On occasion, we work with the blood bank as many of our patients may need blood transfusions. While it may sound confusing to have so many teams involved, your care will be overseen by your OB/GYN who will serve as your constant physician throughout your entire pregnancy.

This multidisciplinary approach works because MAP is such a complex disease, so it’s important to be treated by a team that has extensive knowledge and experience. Our patients can be confident that our team will be as prepared as possible when we enter the operating room. It’s critical to be seen by a team who has a full scope of understanding about your specific MAP.

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