Griffith April M, Dalton Susan E, Kennedy Anne M, Woodward Paula J, Einerson Brett D
Department of Radiology and Imaging Sciences and the Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Utah Health, Salt Lake City, Utah.
Obstet Gynecol. 2025 Jun 1;145(6):739-748. doi: 10.1097/AOG.0000000000005931. Epub 2025 May 2.
Placenta accreta spectrum (PAS) often results in significant maternal morbidity and mortality. Cesarean hysterectomy is the standard treatment in the United States but can be surgically complex and resource-intensive, with significant morbidity. In other countries, conservative management (ie, cesarean delivery with retention of the placenta) is offered as a potentially less morbid option for treatment. Limited data exist to guide postdelivery care of patients undergoing conservative management.
We describe the imaging and clinical findings of six conservatively managed cases of PAS in the weeks after delivery. Imaging findings, including placental cystic changes and development of intrauterine gas, are correlated with the clinical course, time to complete resolution or intervention, and laboratory trends.
Our findings present an expected timeline of postdelivery care for patients with PAS undergoing conservative management, which can help guide future protocols for conservative management of PAS.
ClinicalTrials.gov, NCT05139498.
胎盘植入谱系疾病（PAS）常导致严重的孕产妇发病和死亡。在美国，剖宫产子宫切除术是标准治疗方法，但手术复杂且资源消耗大，发病率高。在其他国家，保守治疗（即剖宫产并保留胎盘）被视为一种潜在发病率较低的治疗选择。目前指导接受保守治疗患者产后护理的数据有限。
我们描述了6例产后数周接受保守治疗的PAS病例的影像学和临床发现。影像学发现，包括胎盘囊性改变和宫内气体形成，与临床病程、完全消退或干预时间以及实验室指标变化相关。
我们的研究结果呈现了接受保守治疗的PAS患者产后护理的预期时间线，这有助于指导未来PAS保守治疗方案。
ClinicalTrials.gov，NCT05139498。
