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Am J Perinatol 2023; 40(09): 970-979
DOI: 10.1055/s-0043-1761636
PAS Series Article
Review Article

Surgical Techniques for the Management of Placenta Accreta Spectrum

Fady Khoury-Collado
1   Division of Gynecologic Oncology, Columbia University Irving Medical Center, New York Presbyterian Hospital, New York, New York
,
J. M. Newton
2   Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, Tennessee
,
Olga R. Brook
3   Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
,
Daniela A. Carusi
4   Department of Obstetrics and Gynecology, Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts
,
Vineet K. Shrivastava
5   Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Memorial Care Miller Children's & Women's Hospital, University of California Irvine, Irvine, California
,
Brian A. Crosland
6   Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, Oregon
,
Karin A. Fox
7   Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas
,
Meena Khandelwal
8   Department of Obstetrics and Gynecology, Cooper Medical School of Rowan University, Camden, New Jersey
,
Amer K. Karam
9   Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Stanford University, Palo Alto, California
,
Kelly A. Bennett
2   Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, Tennessee
,
Adam T. Sandlin
10   Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Arkansas for Medical Sciences, Little Rock, Arkansas
,
Scott A. Shainker
11   Department of Obstetrics, Gynecology, and Reproductive Biology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
,
Brett D. Einerson
12   Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, Utah
,
Michael A. Belfort
13   Departments of Obstetrics and Gynecology, Surgery, Anesthesiology and Neurosurgery, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas
,
for the Pan-American Society for Placenta Accreta Spectrum › Institutsangaben
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Abstract

The surgical management of placenta accreta spectrum (PAS) is often challenging. There are a variety of techniques and management options described in the literature ranging from uterine sparing to cesarean hysterectomy. Following the inaugural meeting of the Pan-American Society for Placenta Accreta Spectrum a multidisciplinary group collaborated to describe collective recommendations for the surgical management of PAS. In this manuscript, we outline individual components of the procedure and provide suggested direction at key points of a cesarean hysterectomy in the setting of PAS.

Key Points

  • The surgical management of PAS requires careful planning and expertise.

  • Multidisciplinary team care for pregnancies complicated by PAS can decrease morbidity and mortality.

  • Careful surgical techniques can minimize risk of significant hemorrhage by avoiding pitfalls.

Keywords

placenta accreta spectrum - surgical treatment - cesarean hysterectomy


Publikationsverlauf

Artikel online veröffentlicht:
19. Juni 2023

© 2023. Thieme. All rights reserved.

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