• Mehmet S Kutuk, Mehmet Ak, and Mahmut T Ozgun.
• Department of Obstetrics and Gynecology, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
• Int J Gynaecol Obstet. 2018 Mar 1; 140 (3): 338-344.

ObjectiveTo compare different treatment methods in the management of placenta accreta spectrum (PAS) disorders.MethodsIn a retrospective cohort study, medical records were retrieved for patients who underwent elective surgery at 24 weeks of pregnancy or more after a diagnosis of PAS disorder (creta, increta, or percreta) at a center in Turkey between May 2, 2010, and August 10, 2016. The final analysis included patients whose diagnosis was confirmed intraoperatively and for whom complete data were available. Patients were divided into three groups: group 1 included those who underwent hysterectomy without placental removal, group 2 included patients whose placenta was left in situ, and group 3 included those who underwent placental removal and conservative surgery.ResultsAmong 79 included patients (33 creta, 18 increta, 28 percreta), 27 (34%) were in group 1, 15 (19%) in group 2, and 37 (47%) in group 3. Total blood loss and the amounts of blood products transfused were lowest in group 2; significant differences between groups were noted (all P ≤ 0.001). Surgical complication rates were similar between groups (4/27 [15%], 1/15 [7%], and 11/37 [30%], respectively; P=0.119). Overall uterine preservation rates were not significantly different between groups 2 and 3 (14/15 [93%] vs 33/37 [89%]; P>0.99).ConclusionLeaving the placenta in situ could become the treatment of choice for PAS disorders.© 2017 International Federation of Gynecology and Obstetrics.

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