[UTERINE PRESERVING METHODS FOR TREATING PLACENTA ACCRETA SPECTRUM: A PROPOSAL FOR A SURGICAL PROTOCOL]

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine

Background:

• Placenta accrete spectrum (PAS) involves abnormal placental implantation, potentially causing severe hemorrhage.
• PAS complications increase maternal and neonatal mortality and morbidity.
• Traditional management often involves hysterectomy to control bleeding.

Purpose of the Study:

• To review uterine-preserving surgical techniques for advanced PAS.
• To propose a surgical protocol for fertility preservation in PAS patients.

Main Methods:

• Review of existing literature on conservative management and surgical approaches for PAS.
• Description of interventional radiology and surgical techniques to reduce uterine blood supply.
• Presentation of a specific surgical protocol used in the authors' medical center.

Main Results:

• Several uterine-preserving techniques exist, including conservative management and methods to reduce placental blood supply.
• These advanced procedures aim to avoid hysterectomy and preserve fertility.
• The proposed protocol offers a structured approach to managing complex PAS cases.

Conclusions:

• Uterus-preserving strategies are viable alternatives for advanced PAS, especially when fertility preservation is desired.
• Advanced surgical techniques and interventional radiology can effectively manage PAS while maintaining reproductive potential.
• The proposed surgical protocol provides a framework for implementing these fertility-sparing procedures.