Candidate for the Lee B. Lusted Student Prize Competition
Purpose: To determine the optimal gestational age for delivery in cases of placenta accreta.
Method: A decision-analytic model was designed to compare gestational age of delivery in placenta accreta for gestational ages between 32 and 37 weeks using maternal and fetal quality-adjusted life years (QALY). At each week of gestational age, we allowed for different delivery strategies: (1) emergent delivery or (2) planned delivery at a predetermined gestational age. Maternal QALYs were calculated based on the probability of maternal hemorrhage requiring transfusion, hysterectomy, maternal death or uncomplicated delivery; fetal QALYs were calculated based on the probability of developing fetal respiratory distress syndrome (RDS), cerebral palsy (CP), fetal demise or no complications.
Result: Delivery at 34 weeks for women with placenta accreta optimizes maternal and neonatal outcomes, resulting in the greatest likelihood of an uncomplicated delivery.
Conclusion: Delivery at 34 weeks for women with placenta accreta optimizes maternal and fetal outcomes.
See more of: The 34th Annual Meeting of the Society for Medical Decision Making