Hysterectomy versus Conservative Uterine Surgery For placenta accreta spectrum | ||
| Evidence Based Women's Health Journal | ||
| Articles in Press, Accepted Manuscript, Available Online from 05 September 2025 | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ebwhj.2025.418267.1503 | ||
| Author | ||
| Malames Mahmoud Salama* | ||
| Obstetric and gynecology , faculty of medicine , ain Shams university | ||
| Abstract | ||
| ABSTRACT Background:. Placenta accreta is described as deep adherence of placental villi to the myometrium. It is caused by a defect in decidua basalis resulting in an abnormally invasive placental implantation. Methods:. A retrospective study (from Jan 2011 to Jan 2017) including 491 cases of placenta accreta, increta or percreta managed on non emergency basis by either conservative surgery or hysterectomy . During the study period, 223 cases were managed by hysterectomy and 268 cases by conservative uterine surgery. Results:. Conservative surgery was associated with lower maternal morbidity compared to hysterectomy in the form of less blood loss (1498 ± 1537 ml versus 2778 ± 1998ml), a lower percentage of patients who received blood transfusion (78.0%) versus (96.4%), fewer transfused blood units (3.6 ± 3.3 versus 6.1 ± 4.8) and a lower insidance of urinary tract injury (7.8%) versus (27.8%). Conservative surgery required significantly less operative time (1.3 ± 0.4 hours versus 3.2 ± 0.7 hours) and shorter hospital stays (4.7 ± 4.0 days versus 6.8 ± 5.9 days). Conclusions:. Conservative uterine surgery for placenta accreta spectrum (PAS) is a good alternative to obstetric hysterectomy, and it is associated with lower maternal morbidity. This approach may be strongly considered in cases of hemodynamic stability with the desire to preserve fertility. | ||
| Keywords | ||
| Obstetric; Maternal , Hemorrhage, Caesarean section, Fertility preservation | ||
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