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Placenta Accreta Spectrum (PAS)

Abnormal adherence of the placenta to the uterine wall; a severe obstetric complication classified as accreta, increta and percreta.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Kadın Hastalıkları ve Doğum department. Book Appointment →

What is Placenta Accreta Spectrum (PAS)?

PAS is a spectrum disorder characterized by abnormally deep attachment of the placenta to the uterine wall. It is classified as accreta (superficial attachment to myometrium), increta (invasion into myometrium) and percreta (invasion through serosa and into adjacent organs). Previous uterine surgery (especially cesarean) is the most important risk factor.

The incidence of PAS is increasing with rising cesarean rates. The risk multiplies when combined with placenta previa. Diagnosis is made by second trimester ultrasonography and magnetic resonance imaging when needed.

PAS carries the risk of massive obstetric hemorrhage at delivery, intensive care need, transfusion, hysterectomy and maternal mortality. Experienced center, multidisciplinary coordination and planned delivery are the cornerstone approach.

Symptoms

Often silent during pregnancy
Painless vaginal bleeding in second-third trimester
Findings of placenta previa
Placental lacunae on ultrasonography
Abnormal vascularization on Doppler
Failure of placental separation after delivery
Sudden massive obstetric bleeding

Risk Factors

Number of previous cesareans
Placenta previa
Previous uterine surgery (myomectomy, curettage, hysteroscopy)
Advanced maternal age
Multiparity
Assisted reproductive techniques

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • In painless second trimester vaginal bleeding
  • When placenta previa is detected in a pregnant woman with previous cesarean
  • On suspicious findings of placental invasion on ultrasonography
  • For routine pre-delivery examination cycle
  • When excessive bleeding or signs of shock develop

Treatment Methods

01
Planned cesarean hysterectomy in tertiary center
02
Urinary catheter, ureteral stents and vascular access preparation
03
Blood and blood product reserve (rapid transfusion protocol)
04
Growth and placental monitoring during pregnancy
05
Multidisciplinary team (obstetrics, anesthesia, urology, interventional radiology)
06
Conservative approaches for fertility preservation (selected cases)

Which Department to Visit?

You can visit our Kadın Hastalıkları ve Doğum department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Kadın Hastalıkları ve Doğum Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.