Placenta Accreta Spectrum: Conservative Management and Its Impact on Future Fertility

Abstract. Placenta accreta spectrum is a complication of pregnancy, which poses a great risk on maternal health. Historically, hysterectomy was the modality of treatment of such condition, but an approach towards a more conservative management has been in the light recently. This includes several me...

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Autores principales:	Riwa A. Abbas, Anwar H. Nassar, Yang Pan
Formato:	article
Lenguaje:	EN
Publicado:	Wolters Kluwer Health 2021
Materias:	Gynecology and obstetrics RG1-991
Acceso en línea:	https://doaj.org/article/09694a1b40c347d8adecbf2f98600848
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spelling	oai:doaj.org-article:09694a1b40c347d8adecbf2f986008482021-11-25T07:59:21ZPlacenta Accreta Spectrum: Conservative Management and Its Impact on Future Fertility2641-589510.1097/FM9.0000000000000077https://doaj.org/article/09694a1b40c347d8adecbf2f986008482021-10-01T00:00:00Zhttp://journals.lww.com/10.1097/FM9.0000000000000077https://doaj.org/toc/2641-5895Abstract. Placenta accreta spectrum is a complication of pregnancy, which poses a great risk on maternal health. Historically, hysterectomy was the modality of treatment of such condition, but an approach towards a more conservative management has been in the light recently. This includes several methods with varying rates of success and complications. Expectant management is effective in up to 78%–80% of the cases. The extirpative method is associated with a high risk of postpartum hemorrhage. The success of the one-step conservative procedure depends on the degree of placental invasion, and the triple-P procedure appears to be successful but requires and interdisciplinary approach. Adjuvant treatment options can be tailored according to individual cases, and these include methotrexate injection, uterine devascularization and hysteroscopic resection of retained placental tissues. Follow up after conservative management is crucial to detect complications early, and it can be done by ultrasound, Doppler examination, and trending β human chorionic gonadotropin levels. Conservative management of placenta accreta spectrum can preserve future fertility but should only be done in hospitals with enough experience as it carries a high risk of maternal complications. In the future, more research should be directed to achieve clear guidelines regarding this topic.Riwa A. AbbasAnwar H. NassarYang PanWolters Kluwer HealtharticleGynecology and obstetricsRG1-991ENMaternal-Fetal Medicine, Vol 3, Iss 4, Pp 263-267 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Gynecology and obstetrics RG1-991
spellingShingle	Gynecology and obstetrics RG1-991 Riwa A. Abbas Anwar H. Nassar Yang Pan Placenta Accreta Spectrum: Conservative Management and Its Impact on Future Fertility
description	Abstract. Placenta accreta spectrum is a complication of pregnancy, which poses a great risk on maternal health. Historically, hysterectomy was the modality of treatment of such condition, but an approach towards a more conservative management has been in the light recently. This includes several methods with varying rates of success and complications. Expectant management is effective in up to 78%–80% of the cases. The extirpative method is associated with a high risk of postpartum hemorrhage. The success of the one-step conservative procedure depends on the degree of placental invasion, and the triple-P procedure appears to be successful but requires and interdisciplinary approach. Adjuvant treatment options can be tailored according to individual cases, and these include methotrexate injection, uterine devascularization and hysteroscopic resection of retained placental tissues. Follow up after conservative management is crucial to detect complications early, and it can be done by ultrasound, Doppler examination, and trending β human chorionic gonadotropin levels. Conservative management of placenta accreta spectrum can preserve future fertility but should only be done in hospitals with enough experience as it carries a high risk of maternal complications. In the future, more research should be directed to achieve clear guidelines regarding this topic.
format	article
author	Riwa A. Abbas Anwar H. Nassar Yang Pan
author_facet	Riwa A. Abbas Anwar H. Nassar Yang Pan
author_sort	Riwa A. Abbas
title	Placenta Accreta Spectrum: Conservative Management and Its Impact on Future Fertility
title_short	Placenta Accreta Spectrum: Conservative Management and Its Impact on Future Fertility
title_full	Placenta Accreta Spectrum: Conservative Management and Its Impact on Future Fertility
title_fullStr	Placenta Accreta Spectrum: Conservative Management and Its Impact on Future Fertility
title_full_unstemmed	Placenta Accreta Spectrum: Conservative Management and Its Impact on Future Fertility
title_sort	placenta accreta spectrum: conservative management and its impact on future fertility
publisher	Wolters Kluwer Health
publishDate	2021
url	https://doaj.org/article/09694a1b40c347d8adecbf2f98600848
work_keys_str_mv	AT riwaaabbas placentaaccretaspectrumconservativemanagementanditsimpactonfuturefertility AT anwarhnassar placentaaccretaspectrumconservativemanagementanditsimpactonfuturefertility AT yangpan placentaaccretaspectrumconservativemanagementanditsimpactonfuturefertility
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Placenta Accreta Spectrum: Conservative Management and Its Impact on Future Fertility

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