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Related Experiment Video

Updated: Oct 7, 2025

Mouse Model of Surgical Uterine Injury and Subsequent Pregnancy Outcomes
04:08

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Placenta accreta spectrum: We can do better.

Cheryl Silveira1, Adrienne Kirby2, Sarah J Melov3,4

  • 1Department of Obstetrics and Gynaecology, Women's and Newborn Health, Westmead Hospital, Sydney, Australia.

The Australian & New Zealand Journal of Obstetrics & Gynaecology
|January 5, 2022
PubMed
Summary
This summary is machine-generated.

Antenatal diagnosis of placenta accreta spectrum (PAS) and multidisciplinary team (MDT) management significantly reduce maternal blood loss and transfusion needs. Elective delivery at 37 weeks optimizes neonatal outcomes in PAS cases.

Keywords:
obstetric labour complicationplacenta accretaplacenta praeviapostpartum haemorrhagepregnancy complications

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Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine
  • Surgical Pathology

Background:

  • Placenta accreta spectrum (PAS) poses significant risks for maternal morbidity.
  • Effective antenatal and peripartum management is crucial for PAS cases.
  • PAS necessitates careful clinical and pathological evaluation.

Purpose of the Study:

  • To compare the management and outcomes of PAS in women with and without antenatal suspicion.
  • To evaluate the impact of multidisciplinary team (MDT) management on PAS outcomes.
  • To analyze clinical courses and histopathological findings in PAS patients.

Main Methods:

  • Retrospective cohort study of hysterectomy specimens diagnosed with PAS.
  • Analysis of clinical data from January 2006 to December 2019 in Western Sydney Local Health District.
  • Comparison of outcomes between antenatally suspected and unsuspected PAS cases, and assessment of MDT impact.

Main Results:

  • Of 70 PAS cases, 54% were antenatally suspected, associated with higher rates of prior Cesarean section, placenta previa, and anterior placenta.
  • Suspected PAS correlated with significantly less maternal blood loss (2000 mL vs 4000 mL) and fewer RBC transfusions (4 vs 9 units).
  • MDT management showed a trend towards reduced blood loss (1500 mL vs 2520 mL) and significantly fewer RBC transfusions (1 vs 6 units).

Conclusions:

  • Antenatal diagnosis of PAS and MDT management are effective in reducing blood loss and transfusion requirements.
  • Elective delivery at 37 weeks gestation is recommended to minimize neonatal risks associated with preterm birth.
  • Both strategies contribute to improved maternal and neonatal outcomes in placenta accreta spectrum management.