ArticleActa obstetricia et gynecologica Scandinavica2022
Uterine conservative-resective surgery for selected placenta accreta spectrum cases: Surgical-vascular control methods.
Article in Acta obstetricia et gynecologica Scandinavica, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05922397 (Evaluation of Clinical Outcomes and Acceptability of an Anatomical Classification for Placenta Accreta Spectrum, a Multicentric Prospective Cohort Study), which is not on this map. Cited by 17 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Evaluation of Clinical Outcomes and Acceptability of an Anatomical Classification for Placenta Accreta Spectrum, a Multicentric Prospective Cohort Study
Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it, 49 citations in OpenAlex.
- Differentiating placenta accreta spectrum from scar dehiscence with underlying, non-adherent placenta: A systematic review of scoring systems and primary data analysis.Acta obstetricia et gynecologica Scandinavica · 2025Pooled it
- Maternal outcomes of conservative management and cesarean hysterectomy for placenta accreta spectrum disorders: a systematic review and meta-analysis.BMC pregnancy and childbirth · 2024Pooled it
- Uterus-preserving surgery for placenta accreta spectrum: An expert, illustrated review of techniques and its outcomes.Acta obstetricia et gynecologica Scandinavica · 2026Review
- Reflective practice in management of morbidly adherent placenta: A four year comparative retrospective study.Pakistan journal of medical sciences · 2026Article
- Strategies for streamlining uterine topographic classification in placenta accreta spectrum.AJOG global reports · 2026Article
- Long-term outcomes in women with placenta accreta spectrum treated by one-step conservative surgery -prospective cohort study.BMC pregnancy and childbirth · 2026Article
- Evaluation of the topographic classification of placenta accreta spectrum: protocol for an ongoing prospective multicenter study.BMC pregnancy and childbirth · 2025Article
- Preoperative cystoscopy as a risk stratification tool for massive hemorrhage in placenta accreta spectrum.BMC pregnancy and childbirth · 2025Article
- The critical role of diagnostic accuracy in differentiating uterine dehiscence and placenta accreta spectrum to enhance neonatal outcomes in complex cesarean sections.BMC pregnancy and childbirth · 2025Article
- The advance grading of intracervical hypervascularity in transvaginal ultrasound indicates a significant risk in Placenta Accreta Spectrum.Acta obstetricia et gynecologica Scandinavica · 2025Article
- Prophylactic internal Iliac artery balloon occlusion in placenta accreta spectrum: evaluating efficacy, risks, and clinical implications.BMC pregnancy and childbirth · 2025Article
- Nonconservative vs. Conservative Management of Antenatally Diagnosed Placenta Accreta Spectrum Disorders: A Literature Review of Approaches and Outcomes.Obstetrics and gynecology international · 2025Review
- Conservative management of placenta previa-percreta with bladder invasion: A case report.Clinical case reports · 2024Article
- Transabdominal and transvaginal ultrasound findings help to guide the clinical management of placenta accreta spectrum cases.Acta obstetricia et gynecologica Scandinavica · 2024Article
- Management of unexpected placenta accreta spectrum cases in resource-poor settings.AJOG global reports · 2023Article
- Comparison of uterine preservation versus hysterectomy in women with placenta accreta: A cross-sectional study.International journal of reproductive biomedicine · 2022Article
- Uterine conservative-resective surgery for selected placenta accreta spectrum cases: Surgical-vascular control methods.Acta obstetricia et gynecologica Scandinavica · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
16 authors at 1 institution in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe incidence of placenta accreta spectrum (PAS) has increased, but the optimal management and the optimal way to achieve vascular control are still controversial. This study aims to compare maternal outcomes between different methods of vascular control in surgical PAS management. MATERIAL AND
methodsA retrospective cohort study on consecutive cases diagnosed with PAS between 2013 and 2020 in single tertiary hospital. The final diagnosis of PAS was made following preoperative ultrasound and confirmation during surgery. Management of PAS using cesarean hysterectomy with internal iliac artery ligation (IIAL) was compared with two types of vascular control in uterine conservative-resective surgery (IIAL vs identification-ligation of the upper vesical, upper vaginal, and uterine arteries).
resultsOver an 8-year period, 234 pregnant women were diagnosed with PAS meeting the inclusion criteria. Uterine conservative-resective surgery (200 cases) was associated with lower mean blood loss compared with cesarean hysterectomy with IIAL (34 cases) in all PAS cases (1379 ± 769 mL vs 3168 ± 1916 mL; p < 0.001). In sub-analysis of the two uterine conservative-resective surgery subgroups, the group with identification-ligation of the upper vesical, upper vaginal, and uterine arteries had a significantly lower blood loss compared with uterine conservative-resective surgery with IIAL (1307 ± 743 mL vs 1701 ± 813 mL; p = 0.005). Women in the hysterectomy with IIAL group had more massive transfusion (35.3% vs 2.5%; p < 0.001; odds ratio [OR] 21.3, 95% confidence interval [CI] 6.9-66), major blood loss (>1500 mL) (70.6% vs 34%, p < 0.001; OR 4.7; 95% CI 2.1-10.3), catastrophic blood loss (>2500 mL) (64.7% vs 12.5%;p < 0.001; OR 12.8, 95% CI 5.7-29.1), other complications (32% vs 12.4%; p = 0.007; OR 3.4, 95% CI 1.5-7.7), and intensive care unit admission (32.4% vs 1.5%; p < 0.001; OR 31.4, 95% CI 8.2-120.7) compared with the uterine conservative-resective surgery groups. The identification-ligation of the upper vesical, upper vaginal and uterine arteries had a significant lower risk for major blood loss (30.5% vs 50%; p = 0.041; OR 0.44, 95% CI = 0.2-0.9) compared with IIAL for vascular control of uterine conservative-resective surgery.
conclusionsCesarean hysterectomy is not the default treatment for PAS, PAS with invasion above the vesical trigone are suitable for uterine conservative-resective surgery with upper vesical, upper vaginal and uterine artery vascular control.
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