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Surgical Morbidity following Planned Hysterectomy versus Conservative Management for Placenta Accreta Spectrum: A Systematic Review and Meta-analysis.
Am J Perinatol
December 2024
Division of Minimally Invasive Gynecology, Department of Obstetrics and Gynecology, Maimonides Medical Center, Brooklyn.
Objective: In recent years, the management of placenta accreta spectrum (PAS) has fallen into two categories: planned hysterectomy and conservative management to preserve fertility. However, optimal management remains unclear. Therefore, we conducted a systematic review and meta-analysis comparing the two to evaluate which approach was associated with lower surgical morbidity.
View Article and Find Full Text PDFPAS or Not PAS? The Sonographic Assessment of Placenta Accreta Spectrum Disorders and the Clinical Validation of a New Diagnostic and Prognostic Scoring System.
J Imaging
December 2024
Obstetrics and Gynaecology Unit, Department of Interdisciplinary Medicine (DIM), University of Bari, 70124 Bari, Italy.
This study aimed to evaluate our center's experience in diagnosing and managing placenta accreta spectrum (PAS) in a high-risk population, focusing on prenatal ultrasound features associated with PAS severity and maternal outcomes. We conducted a retrospective analysis of 102 high-risk patients with confirmed placenta previa who delivered at our center between 2018 and 2023. Patients underwent transabdominal and transvaginal ultrasound scans, assessing typical sonographic features.
View Article and Find Full Text PDFNavigating obstetric enigma: Placenta accreta spectrum masquerading as gestational trophoblastic neoplasia.
Trop Doct
December 2024
Professor and Head, Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Nagpur, Maharashtra, India.
Placenta accreta spectrum (PAS) represents a complex obstetric condition characterised by the abnormal invasion of anchoring villi and trophoblast into the myometrium. This case report explores two instances where the diagnosis of PAS was overlooked during antenatal care leading to significant complications during conservative management. Both patients presented with heavy menstrual bleeding and raised beta human chorionic gonadotrophin (β-hCG), mimicking gestational trophoblastic disease.
View Article and Find Full Text PDFThe role of the intraplacental fetal artery in predicting the need for cesarean-hysterectomy in women at high risk for placenta accreta spectrum.
Placenta
December 2024
Ankara Etlik Lady Zübeyde Women's Health Training and Research Hospital, Department of Obstetrics and Gynecology, Division of Perinatology, P.O. Box 06010, New Etlik Street No:55 Etlik, Keçiören, Ankara, Turkey. Electronic address:
Introduction: Prenatal determination of placenta accreta spectrum (PAS) and its severity is crucial, as it is a highly morbid condition. The aim was to investigate the intraplacental fetal artery (IFA) as a novel ultrasonographic marker in predicting cesarean-hysterectomy need in PAS.
Methods: A prospective observational cohort study was conducted with a total of 62 women with placenta previa and ≥1 previous cesarean-section who were managed for PAS between September 2022 and January 2024.
Integrative multi-omic analysis reveals potential biomarkers in the cervicovaginal fluid of patients with placenta accrete spectrum.
BMC Pregnancy Childbirth
December 2024
Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.
Objective: This study aimed to detect the proteins and metabolites in the cervicovaginal fluid to observe their relationship with the occurrence of placenta accreta spectrum and the potential biomarkers with predictive value.
Methods: Cervicovaginal fluid samples were collected before delivery from 6 participants of PAS and 6 controls subjects with similar gestational ages. The severity of PAS was evaluated by ultrasound and MRI scoring system and confirmed by the intraoperative findings or pathological examination.
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