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Placenta Accreta Spectrum Multidisciplinary Management

PAS management covers antenatal diagnosis, surgical planning and preparation for massive transfusion.

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 Multidisciplinary Management?

PAS is classified as accreta, increta and percreta and varies according to depth of invasion. Increasing number of cesarean sections and coexistence with placenta previa are important risk factors. Antenatal diagnosis is made with ultrasonography and MRI.

Multidisciplinary PAS centers jointly assess maternal-fetal medicine, gynecologic oncology, anesthesia, interventional radiology, urology and the transfusion service. Planned peripartum hysterectomy is the preferred approach, although uterus-sparing protocols may be applied in selected cases.

Antenatal patient management, corticosteroid administration, preoperative ureteral stenting and interventional radiology preparation reduce risks. Delivery is generally planned at 34-35 weeks.

Symptoms

History of prior cesarean and placenta previa
Antenatal ultrasound showing placental lacunae and vascular cascade appearance
MRI signs of uterine serosal invasion
Episodes of vaginal bleeding
Painless bleeding
Uterine tenderness (in percreta cases)

Risk Factors

History of multiple cesarean sections
Placenta previa
Advanced maternal age
Assisted reproductive technologies
Previous uterine surgery (myomectomy)
Asherman syndrome

When to See a Doctor?

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

  • Antenatal diagnosis of placenta previa with cesarean history
  • When vaginal bleeding starts
  • Signs of preterm labor
  • When a center accepts referral for suspected PAS

Treatment Methods

01
Surgical planning with the multidisciplinary PAS team
02
Preoperative ureteral stent placement
03
Aortic balloon occlusion with interventional radiology
04
Planned cesarean hysterectomy
05
Massive transfusion protocol
06
Uterus-sparing techniques (in 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.