Management of the placenta accreta spectrum (PAS) in resource-limited settings poses significant challenges. Traditional approaches, which often involve hysterectomy and extensive technology in all the patients are being replaced by individualized treatment plans considering each patient's specific clinical situation, available resources, and team expertise. Using ultrasonographic and surgical staging based on PAS topographic classification can help design tailored surgical plans and optimize resource use. This article explores the need for personalized PAS management, safe surgical option selection, and how medical teams can adapt to provide more versatile treatment options in resource-constrained environments.
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Placenta Accreta Spectrum Care in Middle-Resource Settings.
Clin Obstet Gynecol
March 2025
Department of Obstetrics and Gynecology, Cairo University, Cairo, Egypt.
Management of the placenta accreta spectrum (PAS) in resource-limited settings poses significant challenges. Traditional approaches, which often involve hysterectomy and extensive technology in all the patients are being replaced by individualized treatment plans considering each patient's specific clinical situation, available resources, and team expertise. Using ultrasonographic and surgical staging based on PAS topographic classification can help design tailored surgical plans and optimize resource use.
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Front Med (Lausanne)
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Clinical Academic Department of Women's Health, CF "University Medical Center", Astana, Kazakhstan.
Introduction: Obstetric hemorrhage is one of the leading causes of maternal mortality and morbidity worldwide. One of the major risk factors of obstetric hemorrhage include placenta previa and placenta accreta spectrum (PAS) disorders. The frequency of PAS disorders is increasing worldwide and is accompanied by massive intraoperative bleeding with hemorrhagic shock and increasing rates of cesarean hysterectomy.
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Immunology, Immunopathology-Immunotherapy-Immunomonitoring Laboratory, Faculty of Medicine, Mohammed VI University of Health Sciences (UM6SS), Casablanca, MAR.
Fundal placenta accreta is a rare and challenging condition characterized by abnormal placental adherence to the myometrium, typically in the upper uterine segment. This case report describes a 35-year-old woman with a history of two previous cesarean sections, who presented at 19 weeks gestation with antepartum hemorrhage and was diagnosed with fundal placenta accreta. Diagnostic imaging, including ultrasound and MRI, revealed a centroplacental hematoma and signs of myometrial invasion, which were confirmed histopathologically after emergency extraction and postpartum management.
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Prior cesarean birth is the most significant predictor of placenta accreta which can place the woman and her infant's lives at risk. With the continuing increase in cesarean birth rate, it is essential that childbirth educators inform women of this life-threatening risk. Insightful information from blogs written by survivors of placenta accreta pregnancies can help guide clinical practice and childbirth education.
View Article and Find Full Text PDFWould internal iliac artery occlusion cause gestational hypertension in the following pregnancy? A population-based study from 2008 to 2017.
Taiwan J Obstet Gynecol
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Department of Gynecology and Obstetrics, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan; Department Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan; School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan. Electronic address:
Objective: In animal models, internal iliac artery occlusion caused gestational hypertension; however, whether this phenomena occurs in humans is still unknown.
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