International Journal of Women's Health (Nov 2020)
Placenta Accreta Spectrum Disorders: Challenges, Risks, and Management Strategies
Abstract
Maddalena Morlando,1 Sally Collins2 1Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology Unit, University of Campania “Luigi Vanvitelli”, Naples, Italy; 2Nuffield Department of Women’s and Reproductive Health, University of Oxford, Fetal Medicine Unit, John Radcliffe Hospital, Oxford, UKCorrespondence: Sally CollinsNuffield Department of Women’s and Reproductive Health, University of Oxford, Fetal Medicine Unit, John Radcliffe Hospital, Oxford, UKTel +44 (0)1865 851165Fax +44 (0) 7958 656 885Email [email protected]: The worldwide incidence of placenta accreta spectrum (PAS) is rapidly increasing, following the trend of rising cesarean delivery. PAS is an heterogeneous condition associated with a high maternal morbidity and mortality rate, presenting unique challenges in its diagnosis and management. So far, the rarity of this condition, together with the absence of high quality evidence and the lack of a standardized approach in reporting PAS cases for the ultrasound, clinical, and pathologic diagnosis, represented the main challenges for a deep understanding of this condition. The study of the available management strategies of PAS has been hampered by the heterogeneity of the available epidemiological data on this condition. The aim of this review is to provide a critical view of the current available evidence on the screening, the diagnosis, and the management options for PAS disorders, with a special focus on the challenges we foresee for the near future.Keywords: placenta accreta spectrum, placenta accreta, abnormal placentation, abnormal invasive placenta, morbidly adherent placenta
