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The Management of Placenta Accreta Spectrum Disorder
Bridget M Donovan1, Lisa C Zuckerwise
1University of Virginia, Charlottesville, Virginia.
Insights
This review covers placenta accreta spectrum (PAS) management, a high-risk pregnancy condition. Multidisciplinary care is vital, but research is needed to optimize patient outcomes and surgical approaches.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
Background:
- Placenta accreta spectrum (PAS) is a severe obstetric complication with increasing incidence.
- PAS poses significant risks for maternal hemorrhage and surgical morbidity.
Purpose of the Study:
- To review current management strategies for placenta accreta spectrum (PAS).
- To guide clinical management from diagnosis through postpartum care.
- To highlight areas of uncertainty and the need for further research.
Main Methods:
- Review of available data and literature on PAS management.
- Emphasis on team-based, patient-centered, and multidisciplinary care approaches.
Main Results:
- Current evidence strongly supports multidisciplinary care for PAS patients.
- Management strategies are guided by expert opinion in many uncertain areas.
- Optimization of patient outcomes requires further research into management and surgical techniques.
Conclusions:
- Multidisciplinary, patient-centered care is crucial for managing placenta accreta spectrum.
- Significant uncertainties remain, necessitating continued research.
- Further investigation into management and surgical approaches is paramount for improving patient outcomes and experience.
Abstract:
This chapter provides insight into current management strategies for the placenta accreta spectrum (PAS). PAS is one of the most morbid conditions of pregnancy, with significant maternal hemorrhage and surgical morbidity risks, and its increasing incidence. Here, we review the available data to help guide the clinical management of PAS, from time of diagnosis through delivery and postpartum care, while acknowledging the many areas of continued uncertainty. The evidence is strong for the importance of team-based, patient-centered, and multidisciplinary care for patients with PAS. However, much else remains uncertain and is predominantly guided by expert opinion. Ultimately, we aim to provide a current understanding of available literature and to emphasize that continued research is paramount to explore management and surgical approaches to move toward optimization of patient outcomes, including the patient experience.
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