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Placenta accreta spectrum-a catastrophic situation in obstetrics
Bhabani Pegu,Chitra Thiagaraju,Deepthi Nayak,Murali Subbaiah 대한산부인과학회 2021 Obstetrics & Gynecology Science Vol.64 No.3
Placenta accreta is a significant obstetric complication in which the placenta is completely or focally adherent to themyometrium. The worldwide incidence of placenta accreta spectrum (PAS) is increasing day by day, mostly due tothe increasing trends in cesarean section rates. The accurate and timely diagnosis of placenta accreta is important toimprove the feto-maternal outcome. Although standard ultrasound is a reliable and primary tool for the diagnosis ofplacenta accreta, the absence of ultrasound findings does not preclude the diagnosis of placenta accreta. Therefore,clinical evaluation of risk factors is equally essential for the prediction of abnormal placental invasion. Pregnantwomen with a high impression or established diagnosis of placenta accreta should be managed by a multidisciplinaryteam in a specialist center. Traditionally, PAS has been managed by an emergency obstetric hysterectomy. Previously,few studies suggested a satisfactory success rate of conservative management in well-chosen cases, whereas fewstudies recommended delayed hysterectomy to reduce the amount of bleeding. The continuously increasing trends ofPAS and the challenges for its routine management are the main motives behind this literature review.
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