Clinical and Radiologic Evolution in Conservative Management of Placenta Accreta Spectrum Disorder.

Abstract

Placenta accreta spectrum (PAS) often results in significant maternal morbidity and mortality. Cesarean hysterectomy is the standard treatment in the United States but can be surgically complex and resource-intensive, with significant morbidity. In other countries, conservative management (ie, cesarean delivery with retention of the placenta) is offered as a potentially less morbid option for treatment. Limited data exist to guide postdelivery care of patients undergoing conservative management. We describe the imaging and clinical findings of six conservatively managed cases of PAS in the weeks after delivery. Imaging findings, including placental cystic changes and development of intrauterine gas, are correlated with the clinical course, time to complete resolution or intervention, and laboratory trends. Our findings present an expected timeline of postdelivery care for patients with PAS undergoing conservative management, which can help guide future protocols for conservative management of PAS. ClinicalTrials.gov, NCT05139498.