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Indicated preterm birth for placenta accreta.

Michael A Belfort1

  • 1Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX 77030, USA. Belfort@BCM.edu

Seminars in Perinatology
|October 4, 2011
PubMed
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Scheduled preterm delivery for placenta accreta spectrum disorders offers benefits but requires careful timing. Optimal delivery is between 34-35 weeks gestation, based on current evidence.

Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine

Background:

  • Placenta accreta spectrum (PAS) disorders, including accreta, increta, and percreta, are increasingly prevalent.
  • These conditions pose significant risks during pregnancy and delivery.

Purpose of the Study:

  • To review the risks and benefits of scheduled preterm delivery in patients with PAS.
  • To provide evidence-based guidance on optimal delivery timing for these complex cases.

Main Methods:

  • A comprehensive literature search was conducted using PubMed (1990-2010) with keywords related to PAS and preterm delivery timing.
  • Included studies were evaluated for quality based on the U.S. Preventative Services Task Force criteria.
  • Additional data sourced from reference lists, review articles, and professional guidelines.

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Main Results:

  • Evidence from randomized controlled trials and well-controlled observational studies regarding optimal delivery timing is limited.
  • Case series, retrospective reviews, and decision analysis studies were the primary sources of information.
  • Abnormal placentation is a growing concern in obstetric practice.

Conclusions:

  • Optimal delivery timing for placenta accreta spectrum disorders is challenging due to limited high-quality evidence.
  • Current best evidence suggests delivery between 34 and 35 weeks of gestation is optimal for most cases.
  • Further research is needed to establish definitive best practices.