Placenta Accreta Spectrum: Prenatal Diagnosis and Management

Rebecca Horgan; Alfred Abuhamad

doi:10.1016/j.ogc.2022.02.004

Placenta Accreta Spectrum: Prenatal Diagnosis and Management

Obstet Gynecol Clin North Am. 2022 Sep;49(3):423-438. doi: 10.1016/j.ogc.2022.02.004.

Authors

Rebecca Horgan¹, Alfred Abuhamad²

Affiliations

¹ Division of Maternal Fetal Medicine, Department of Obstetrics & Gynecology, Eastern Virginia Medical School, 825 Fairfax Avenue, Suite 528, Norfolk, VA 23507, USA. Electronic address: horganr@evms.edu.
² Division of Maternal Fetal Medicine, Department of Obstetrics & Gynecology, Eastern Virginia Medical School, 825 Fairfax Avenue, Suite 528, Norfolk, VA 23507, USA.

PMID: 36122977
DOI: 10.1016/j.ogc.2022.02.004

Abstract

The incidence of placenta accreta spectrum (PAS) is increasing and is now about 3 per 1000 deliveries, largely due to the rising cesarean section rate. Ultrasound is the preferred method for diagnosis of PAS. Ultrasound markers include multiple vascular lacunae, loss of the hypoechoic retroplacental zone, abnormalities of the uterine serosa-bladder interface, retroplacental myometrial thickness less than 1 mm, increased placental vascularity, and observation of bridging vessels linking the placenta and bladder. Patients with PAS should be managed by experienced multidisciplinary teams. Hysterectomy is the accepted management of PAS and conservative or expectant management of PAS should be considered investigational.

Keywords: Abnormal placentation; Diagnosis; Management; Placenta accreta spectrum; Ultrasound.

Publication types

Review

MeSH terms

Cesarean Section
Female
Humans
Placenta / diagnostic imaging
Placenta Accreta* / diagnostic imaging
Placenta Accreta* / surgery
Pregnancy
Prenatal Diagnosis
Ultrasonography, Prenatal / methods