Leaving Placenta In Situ Safe Alternative to Cesarean Hysterectomy in placenta accreta spectrum disorder: Study
A recent study published in Obstetrics & Gynecology suggests that leaving the placenta in situ may be a safe alternative to cesarean hysterectomy for women with placenta accreta spectrum (PAS) disorders. The retrospective cohort study, conducted at the University of Texas Health Science Center at Houston, evaluated maternal outcomes in patients managed conservatively by leaving the placenta in place from January 2015 to October 2024.
The findings indicate that, for most women, this approach did not result in serious complications such as infection or severe bleeding, offering a potential uterus-preserving option in select cases.
In the study, 50 patients with antenatal diagnoses of PAS were planned for conservative management by leaving the placenta in situ. Of these, 43 (86%) were successfully managed without immediate hysterectomy. Among these 43 patients, 5 (12%) eventually required hysterectomy due to bleeding, and 4 (9%) developed endometritis. Notably, there were no cases of venous thromboembolism or maternal death reported. Furthermore, among the 29 patients who were planned for uterine preservation, 13 (45%) achieved successful uterine preservation, with a median time to placental resorption or expulsion of 17 weeks.
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