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Conservative Surgical Management of Placenta Accreta Spectrum: A Pragmatic Approach

Joanna Sichitiu1, Zeina El-Tani1, Patrice Mathevet1

  • 1Women-Mother-Child Department, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.

Journal of Investigative Surgery : the Official Journal of the Academy of Surgical Research
|August 21, 2019
PubMed

In the last 30 years, with increasing cesarean section rates, the incidence of the placenta accreta spectrum has also increased. It is estimated that by the year 2020 there will be nearly 9000 cases annually in the United States. Currently, no consensus exists regarding optimal management. Conventional treatment by cesarean-hysterectomy is challenging, with a high maternal morbidity due to massive hemorrhage, and surgical complications such as urinary tract, bowel and pelvic nerve injury, in addition to loss of fertility and its accompanying psychological trauma. Innovative approaches seek to preserve the uterus with the adherent placenta in situ, thus maintaining fertility and potentially reducing hemorrhage and adjacent organ injury. This review reports strategies for conservative treatment of such conditions, based on the current literature.

Keywords:
accretaconservative managementcretaincretainvasive placentapercretaplacenta accreta spectrumuterine preservation

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