Posterior Placenta Accreta Spectrum Disorders: Risk Factors, Diagnostic Accuracy, and Surgical Management

Abstract. Posterior placenta accreta spectrum (PAS) disorders are infrequent but potentially associated with significant maternal mortality and morbidity, especially if not diagnosed prenatally. Analysis of published literature is problematic since most experiences included only a few cases. Knowled...

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Autores principales:	José Miguel Palacios-Jaraquemada, Francesco D’Antonio, Yang Pan
Formato:	article
Lenguaje:	EN
Publicado:	Wolters Kluwer Health 2021
Materias:	Gynecology and obstetrics RG1-991
Acceso en línea:	https://doaj.org/article/cd2aaaba8b344c6d82a47ec3b968925e
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spelling	oai:doaj.org-article:cd2aaaba8b344c6d82a47ec3b968925e2021-11-25T07:59:21ZPosterior Placenta Accreta Spectrum Disorders: Risk Factors, Diagnostic Accuracy, and Surgical Management2641-589510.1097/FM9.0000000000000124https://doaj.org/article/cd2aaaba8b344c6d82a47ec3b968925e2021-10-01T00:00:00Zhttp://journals.lww.com/10.1097/FM9.0000000000000124https://doaj.org/toc/2641-5895Abstract. Posterior placenta accreta spectrum (PAS) disorders are infrequent but potentially associated with significant maternal mortality and morbidity, especially if not diagnosed prenatally. Analysis of published literature is problematic since most experiences included only a few cases. Knowledge of the risk factors associated with posterior PAS is crucial to identifying mothers at higher risk and ask for high sensitivity studies. Ultrasound has poor diagnostic accuracy in detecting posterior PAS, while magnetic resonance imaging better delineates the posterior uterine wall. In comparison, prenatal imaging's diagnostic performance in detecting posterior PAS is significantly lower than anterior placenta invasion. Management of posterior PAS depends on several factors, including maternal hemodynamic status, available resources, clinical presentation, and invasion severity. For accreta or increta cases, a compression suture is habitually enough to perform hemostasis. Nevertheless, organ involvement habitually requires a multidisciplinary team with the assistant of a general or coloproctology surgeon. The present article aims to update the risk factors, prenatal diagnosis, and surgical management of pregnancies complicated by posterior PAS.José Miguel Palacios-JaraquemadaFrancesco D’AntonioYang PanWolters Kluwer HealtharticleGynecology and obstetricsRG1-991ENMaternal-Fetal Medicine, Vol 3, Iss 4, Pp 268-273 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Gynecology and obstetrics RG1-991
spellingShingle	Gynecology and obstetrics RG1-991 José Miguel Palacios-Jaraquemada Francesco D’Antonio Yang Pan Posterior Placenta Accreta Spectrum Disorders: Risk Factors, Diagnostic Accuracy, and Surgical Management
description	Abstract. Posterior placenta accreta spectrum (PAS) disorders are infrequent but potentially associated with significant maternal mortality and morbidity, especially if not diagnosed prenatally. Analysis of published literature is problematic since most experiences included only a few cases. Knowledge of the risk factors associated with posterior PAS is crucial to identifying mothers at higher risk and ask for high sensitivity studies. Ultrasound has poor diagnostic accuracy in detecting posterior PAS, while magnetic resonance imaging better delineates the posterior uterine wall. In comparison, prenatal imaging's diagnostic performance in detecting posterior PAS is significantly lower than anterior placenta invasion. Management of posterior PAS depends on several factors, including maternal hemodynamic status, available resources, clinical presentation, and invasion severity. For accreta or increta cases, a compression suture is habitually enough to perform hemostasis. Nevertheless, organ involvement habitually requires a multidisciplinary team with the assistant of a general or coloproctology surgeon. The present article aims to update the risk factors, prenatal diagnosis, and surgical management of pregnancies complicated by posterior PAS.
format	article
author	José Miguel Palacios-Jaraquemada Francesco D’Antonio Yang Pan
author_facet	José Miguel Palacios-Jaraquemada Francesco D’Antonio Yang Pan
author_sort	José Miguel Palacios-Jaraquemada
title	Posterior Placenta Accreta Spectrum Disorders: Risk Factors, Diagnostic Accuracy, and Surgical Management
title_short	Posterior Placenta Accreta Spectrum Disorders: Risk Factors, Diagnostic Accuracy, and Surgical Management
title_full	Posterior Placenta Accreta Spectrum Disorders: Risk Factors, Diagnostic Accuracy, and Surgical Management
title_fullStr	Posterior Placenta Accreta Spectrum Disorders: Risk Factors, Diagnostic Accuracy, and Surgical Management
title_full_unstemmed	Posterior Placenta Accreta Spectrum Disorders: Risk Factors, Diagnostic Accuracy, and Surgical Management
title_sort	posterior placenta accreta spectrum disorders: risk factors, diagnostic accuracy, and surgical management
publisher	Wolters Kluwer Health
publishDate	2021
url	https://doaj.org/article/cd2aaaba8b344c6d82a47ec3b968925e
work_keys_str_mv	AT josemiguelpalaciosjaraquemada posteriorplacentaaccretaspectrumdisordersriskfactorsdiagnosticaccuracyandsurgicalmanagement AT francescodantonio posteriorplacentaaccretaspectrumdisordersriskfactorsdiagnosticaccuracyandsurgicalmanagement AT yangpan posteriorplacentaaccretaspectrumdisordersriskfactorsdiagnosticaccuracyandsurgicalmanagement
_version_	1718413586304335872

Posterior Placenta Accreta Spectrum Disorders: Risk Factors, Diagnostic Accuracy, and Surgical Management

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