Division of Gynecologic Oncology, Columbia University Irving Medical Center, New York Presbyterian Hospital, New York, New York.
Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, Tennessee.
Am J Perinatol. 2023 Jul;40(9):970-979. doi: 10.1055/s-0043-1761636. Epub 2023 Jun 19.
The surgical management of placenta accreta spectrum (PAS) is often challenging. There are a variety of techniques and management options described in the literature ranging from uterine sparing to cesarean hysterectomy. Following the inaugural meeting of the Pan-American Society for Placenta Accreta Spectrum a multidisciplinary group collaborated to describe collective recommendations for the surgical management of PAS. In this manuscript, we outline individual components of the procedure and provide suggested direction at key points of a cesarean hysterectomy in the setting of PAS. KEY POINTS: · The surgical management of PAS requires careful planning and expertise.. · Multidisciplinary team care for pregnancies complicated by PAS can decrease morbidity and mortality.. · Careful surgical techniques can minimize risk of significant hemorrhage by avoiding pitfalls..
胎盘植入谱系疾病（PAS）的外科治疗常常具有挑战性。文献中描述了各种技术和管理选择，范围从保留子宫到剖宫产子宫切除术。在首届泛美胎盘植入谱系疾病学会会议之后，一个多学科小组合作描述了 PAS 外科治疗的集体建议。在本文中，我们概述了该手术的各个组成部分，并在 PAS 剖宫产子宫切除术的关键部位提供了建议。
· PAS 的外科治疗需要精心的计划和专业知识。
· 多学科团队对 PAS 合并妊娠的护理可以降低发病率和死亡率。
· 谨慎的手术技术可以通过避免陷阱来最大限度地降低大出血的风险。
