In Favor: Conservative Management of Placenta Accreta

Conservative management of placenta accreta spectrum is increasingly recognized as a clinically valid, evidence-based alternative to cesarean hysterectomy, enabling reduction of maternal morbidity, particularly for women desiring fertility preservation. Prospective studies demonstrate that conservative management is associated with substantially reduced hemorrhagic morbidity and lower organ injury rates compared with cesarean hysterectomy. Trade-offs include delayed postpartum hemorrhage, higher infection, and readmission rates. Conservative management involves prolonged clinical and ultrasound follow-up. Its success requires patient selection, and its safe implementation demands geographic proximity to a referral center, and availability of a multidisciplinary team 24/7 to manage potential acute complications.