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Semin intervent Radiol 2023; 40(05): 467-471
DOI: 10.1055/s-0043-1772815
Clinical Corner

Placenta Accreta Spectrum: An Overview

Abheek Ghosh
1   Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Maryland
,
Sean Lee
2   Touro College of Osteopathic Medicine, New York City, New York
,
Christina Lim
3   Creighton University School of Medicine, Omaha, Nebraska
,
Robert L. Vogelzang
4   Division of Interventional Radiology, Department of Radiology, Northwestern University, Chicago, Illinois
,
Howard B. Chrisman
4   Division of Interventional Radiology, Department of Radiology, Northwestern University, Chicago, Illinois
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Placenta accreta spectrum (PAS) is a clinical condition generally defined by the invasion of placental tissue into the wall of the uterus. More specifically, PAS refers to placenta accreta, placenta increta, and placenta percreta, which encapsulates a range of pathologic adherence of the placenta to the myometrial wall based on the depth of trophoblast penetration. Placenta accreta is the most common and least invasive form of PAS, while placenta percreta is the least common yet most invasive subtype ([Fig. 1]).[1] During delivery, PAS carries a significant risk for life-threatening hemorrhage and is associated with increased rates of maternal morbidity and mortality. Although modern imaging modalities such as ultrasound and magnetic resonance imaging (MRI) have provided valuable avenues to guide preoperative delivery planning, cesarean hysterectomy, the current gold-standard technique for PAS, does not allow patients the chance to preserve fertility.[2] With the ever-so-increasing rates of PAS in pregnancies over the last decade, it is imperative for physicians to strategize alternative treatment and prophylactic options for these patients that not only maximize clinical outcomes but also preserve fecundity.[3]

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Fig. 1 Placenta accreta spectrum (PAS) refers to a range of pathologic adherence of the placenta to the myometrial wall of the uterus. Among the three categories of PAS depicted, placenta accreta is the least invasive yet most common subtype, being responsible for 75–78% of all PAS cases.


Publication History

Article published online:
02 November 2023

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