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Related Experiment Video

Updated: Aug 16, 2025

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

Mouse Model of Surgical Uterine Injury and Subsequent Pregnancy Outcomes

Published on: June 27, 2025

243

Comprehensive surgical staging for placenta accreta spectrum.

José M Palacios-Jaraquemada1,2,3, Nicolás Basanta2,4, Álbaro Nieto-Calvache5

  • 1Department of Obgyn, CEMIC University Hospital and Universitas Airlangga, Surabaya, Indonesia.

The Journal of Maternal-Fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
|December 21, 2022
PubMed
Summary

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Articles linked to this work by shared authors, journal, and citation graph.

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Same author

Towards precision medicine in placenta accreta spectrum: results from a survey-based evaluation of interactive academic international webinars.

BMC pregnancy and childbirth·2026
Same author

Uterus-preserving surgery for placenta accreta spectrum: An expert, illustrated review of techniques and its outcomes.

Acta obstetricia et gynecologica Scandinavica·2026
Same author

The INAPRES (Indonesia preeclampsia study): Clinical outcomes of acute kidney injury related to preeclampsia in Indonesia.

Pregnancy hypertension·2026
Same author

How to avoid placental transection during low transverse cesarean delivery for anterior placenta previa.

American journal of obstetrics and gynecology·2026
Same author

Correction: Evaluation of the topographic classification of placenta accreta spectrum: protocol for an ongoing prospective multicenter study.

BMC pregnancy and childbirth·2026
Same author

Beyond sutures: incorporating vascular insights into cesarean closure discussions (letter to the editor).

American journal of obstetrics and gynecology·2026

Comprehensive surgical staging (CSS) accurately determines the extent of placenta accreta spectrum (PAS) invasion, improving prenatal diagnosis efficacy by 50% and guiding surgical decisions for better patient outcomes.

Area of Science:

  • Obstetrics and Gynecology
  • Surgical Oncology
  • Fetal Medicine

Background:

  • Placenta accreta spectrum (PAS) poses significant risks during pregnancy and delivery.
  • Accurate prenatal diagnosis and surgical planning are crucial for managing PAS.
  • Current diagnostic methods may have limitations in precisely defining the extent of placental invasion.

Purpose of the Study:

  • To evaluate the precision of surgical staging after prenatal diagnosis in patients with PAS.
  • To assess the impact of comprehensive surgical staging (CSS) on diagnostic accuracy and surgical strategy.

Main Methods:

  • Retrospective cohort study of 622 women with PAS undergoing surgery (2000-2020).
  • Prenatal diagnosis utilized ultrasound and T2-weighted MRI.
Keywords:
Placenta accreta spectrumcomprehensive surgical stagingintraoperative diagnosispelvic fascia dissection

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  • Comprehensive surgical staging (CSS) involved detailed dissection of pelvic fascial planes and classification of lateral, anterior, and posterior uterine wall invasion.

    • Main Results:

    • CSS enhanced the efficacy of prenatal diagnostic studies (ultrasound and MRI) by up to 50%.
    • Identification of parametrial invasion (type 2 PAS) or retrovesical invasion led to immediate modifications in surgical tactics and vascular control.
    • Deep interfacial dissection facilitated identification of healthy uterine tissue, enabling conservative reconstructive procedures instead of hysterectomy.

    Conclusions:

    • Comprehensive surgical staging (CSS) is an excellent tool for precisely determining the extent and specific topography of placental invasion in PAS.
    • CSS improves the accuracy of prenatal diagnosis and significantly influences surgical planning and management.
    • This staging method aids in optimizing surgical approaches, potentially preserving uterine function.