Table Of ContentPlacenta
Accreta
Spectrum
Basic Science, Diagnosis,
Classification and
Management
Sherif A. Shazly
Ahmed A. Nassr
Editors
123
Placenta Accreta Spectrum
Sherif A. Shazly • Ahmed A. Nassr
Editors
Placenta Accreta Spectrum
Basic Science, Diagnosis, Classification
and Management
Editors
Sherif A. Shazly Ahmed A. Nassr
Department of Obstetrics and Gynecology Department of Obstetrics and Gynecology
Leeds Teaching Hospitals NHS Trust Baylor College of Medicine
Leeds, UK Houston, TX, USA
ISBN 978-3-031-10346-9 ISBN 978-3-031-10347-6 (eBook)
https://doi.org/10.1007/978-3-031-10347-6
© The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature
Switzerland AG 2023
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Contents
1 History of Placenta Accreta Spectrum . . . . . . . . . . . . . . . . . . . . . . . . . 1
Nashwa Anwar Eltaweel and Ahmed Y. Hefnawy
2 Epidemiology of Placenta Accreta Spectrum:
A Comprehensive Review of Current Evidence . . . . . . . . . . . . . . . . . . 5
Alekhya Chintamani and Boon Lim
3 Pathogenesis of Placenta Accreta Spectrum . . . . . . . . . . . . . . . . . . . . . 23
Erbil Karaman, Deniz Dirik, and Onur Karaaslan
4 Anatomy of Placenta Accreta Spectrum . . . . . . . . . . . . . . . . . . . . . . . . 29
José M. Palacios-Jaraquemada, Nicolás Basanta,
Álbaro Nieto-Calvache, and Rozi Aditya Aryananda
5 Classification of Placenta Accreta Spectrum . . . . . . . . . . . . . . . . . . . . 45
Rozi Aditya Aryananda and Grace Ariani
6 Diagnosis of Placenta Accreta Spectrum: Clinical
and Radiological Diagnosis of Placenta Accreta Spectrum
and the Ability of Sonographic and MRI Findings
to Predict Definitive Diagnosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63
Bahram Salmanian, Scott A. Shainker, Alireza A. Shamshirsaz,
and Ahmed A. Nassr
7 Definitive Management of Placenta Accreta Spectrum . . . . . . . . . . . . 73
Pedro Viana Pinto, Ana Paula Machado, and Marina Moucho
8 Conservative Management of Placenta Accreta Spectrum . . . . . . . . . 87
Ismet Hortu, Elif Yagmur Erdem, and Ahmet Mete Ergenoglu
9 Adjunctive Treatment of Placenta Accreta Spectrum . . . . . . . . . . . . . 97
Sohum C. Shah, Karin A. Fox, and Ahmed A. Nassr
v
vi Contents
10 Prediction and Risk Reduction of Clinical Outcomes
of Placenta Accreta Spectrum . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107
Mohamed I. Ateya, Ahmed S. Sedik, Islam A. Ahmed,
Mostafa H. Abouzeid, and Sherif A. Shazly
11 Evidence-Based Management of Placenta Accreta Spectrum . . . . . . 117
Sherif A. Shazly, Ahmad A. Radwan, AlBatool M. AlMahdy,
Mohamed I. Ateya, Mostafa H. Abouzeid, Esraa G. Sayed,
and Gena M. Elassall
12 Prevention of Placenta Accreta Spectrum Disorders . . . . . . . . . . . . . . 139
Tatiana B. Makukhina and Grigory A. Penzhoyan
13 Setting Up a Referral Center for Placenta Accreta Spectrum . . . . . . 155
Sarah Tounsi, Karin A. Fox, Michael A. Belfort,
and Ahmed A. Nassr
14 Management of PAS in Low-Resource Settings . . . . . . . . . . . . . . . . . . 161
Dema Adwan, Ahed Hamed, Mustafa Albokai,
and Mhd Ali Alabdulrazak
15 Management of Placenta Accreta Spectrum
in the Second Trimester . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 185
Omima T. Taha, Maryam Abdelkarim, Nourah Al Qahtani,
and Ayman S. Dawood
16 Long-Term Outcomes of Conservative Management of PAS:
Long-Term Sequences and Impact on Future Pregnancies . . . . . . . . 193
Mahmoud A. Abdel-Aleem
Contributors
Mahmoud A. Abdel-Aleem Department of Obstetrics and Gynecology, Assiut
University, Assiut, Egypt
Maryam Abdelkarim Obstetrics and Gynecology Department, Faculty of
Medicine, Alexandria University, Alexandria, Egypt
Mostafa H. Abouzeid Women Health Hospital, Assiut University, Assiut, Egypt
Department of Obstetrics and Gynecology, Assiut University, Assiut, Egypt
Dema Adwan Department of Obstetrics & Gynecology, Damascus University,
Damascus, Syria
University Hospital of Obstetrics and Gynecology, Damascus University,
Damascus, Syria
Islam A. Ahmed Faculty of Medicine, Assiut University, Assiut, Egypt
Mhd Ali Alabdulrazak Faculty of Medicine, Damascus University,
Damascus, Syria
Mustafa Albokai Faculty of Medicine, Damascus University, Damascus, Syria
AlBatool M. AlMahdy Faculty of Medicine, Assiut University, Assiut, Egypt
Grace Ariani Department of Anatomical Pathology, Dr. Soetomo Academic
General Hospital, Universitas Airlangga, Surabaya, Indonesia
Rozi Aditya Aryananda Dr. Soetomo Academic General Hospital, Universitas
Airlangga, Surabaya, Indonesia
Mohamed I. Ateya Department of Obstetrics and Gynecology, South Valley
University, Qena, Egypt
Nicolás Basanta Fernández Hospital and School of Medicine, 1° Anatomy Chair,
University of Buenos Aires, Buenos Aires, Argentina
vii
viii Contributors
Michael A. Belfort Department of Obstetrics and Gynecology, Baylor College of
Medicine and Texas Children’s Hospital, Houston, TX, USA
Alekhya Chintamani Department of Obstetrics and Gynaecology, Canberra
Health Services, Canberra, ACT, Australia
Ayman S. Dawood Obstetrics and Gynecology Department, Faculty of Medicine,
Tanta University, Tanta, Egypt
Deniz Dirik Medical Faculty, Department of Obstetrics and Gynecology, Van
Yuzuncu Yil University, Van, Turkey
Gena M. Elassall Faculty of Medicine, Assiut University, Assiut, Egypt
Nashwa Anwar Eltaweel Department of Obstetrics and Gynaecology, University
Hospitals of Coventry and Warwickshire, Coventry, UK
Elif Yagmur Erdem Department of Obstetrics and Gynecology, Ege University
School of Medicine, Izmir, Turkey
Ahmet Mete Ergenoglu Department of Obstetrics and Gynecology, Ege University
School of Medicine, Izmir, Turkey
Karin A. Fox Department of Obstetrics and Gynecology, Baylor College of
Medicine and Texas Children’s Hospital, Houston, TX, USA
Ahed Hamed Department of Obstetrics & Gynecology, Damascus University,
Damascus, Syria
Al Zahrawi Maternity Hospital, Damascus, Syria
Ahmed Y. Hefnawy Department of Obstetrics and Gynaecology, The Northern
Care Alliance NHG group, Oldham, Manchester, UK
Ismet Hortu Department of Obstetrics and Gynecology, Ege University School of
Medicine, Izmir, Turkey
Onur Karaaslan Medical Faculty, Department of Obstetrics and Gynecology, Van
Yuzuncu Yil University, Van, Turkey
Erbil Karaman Medical Faculty, Department of Obstetrics and Gynecology,
Division of Gynecologic Oncology, Van Yuzuncu Yil University, Van, Turkey
Boon Lim Department of Obstetrics and Gynaecology, Canberra Health Services,
Canberra, ACT, Australia
Australian National University, Canberra, ACT, Australia
Ana Paula Machado Serviço de Ginecologia e Obstetrícia, Centro Hospitalar São
João, Porto, Portugal
Tatiana B. Makukhina Federal State Budgetary Educational Institution of Higher
Education “Kuban State Medical University” of the Ministry of Healthcare of the
Russian Federation, Faculty of Postgraduate Education, Department of Obstetrics,
Gynecology and Perinatology, Krasnodar, Russia
Contributors ix
Marina Moucho Serviço de Ginecologia e Obstetrícia, Centro Hospitalar São
João, Porto, Portugal
Ahmed A. Nassr Department of Obstetrics and Gynecology, Baylor College of
Medicine and Texas Children’s Hospital, Houston, TX, USA
Álbaro Nieto-Calvache Placenta Accreta Spectrum Clinic, Fundación Valle del
Lili, Cali, Colombia
José M. Palacios-Jaraquemada CEMIC University Hospital and 1° Anatomy
Chair, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina
Universitas Airlangga, Surabaya, Indonesia
Grigory A. Penzhoyan Federal State Budgetary Educational Institution of Higher
Education “Kuban State Medical University” of the Ministry of Healthcare of the
Russian Federation, Faculty of Postgraduate Education, Department of Obstetrics,
Gynecology and Perinatology, Krasnodar, Russia
Pedro Viana Pinto Serviço de Ginecologia e Obstetrícia, Centro Hospitalar São
João, Porto, Portugal
Faculdade de Medicina, Universidade do Porto, Porto, Portugal
Nourah Al Qahtani Obstetrics and Gynecology Department, Imam Abdulrahman
Bin Faisal University, Dammam, Kingdom of Saudi Arabia
Ahmad A. Radwan Faculty of Medicine, Assiut University, Assiut, Egypt
Bahram Salmanian Department of Obstetrics and Gynecology, Baylor College of
Medicine and Texas Children’s Hospital, Houston, TX, USA
Esraa G. Sayed Faculty of Medicine, Assiut University, Assiut, Egypt
Ahmed S. Sedik Faculty of Medicine, Assiut University, Assiut, Egypt
Sohum C. Shah Department of Obstetrics and Gynecology, Baylor College of
Medicine and Texas Children’s Hospital, Houston, TX, USA
Scott A. Shainker New England Center for Placental Disorders, Beth Israel
Deaconess Medical Center, Boston, MA, USA
Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical
School, Boston, MA, USA
Alireza A. Shamshirsaz Department of Obstetrics and Gynecology, Baylor
College of Medicine and Texas Children’s Hospital, Houston, TX, USA
Sherif A. Shazly Department of Obstetrics and Gynecology, Leeds Teaching
Hospitals NHS Trust, Leeds, UK
Omima T. Taha Obstetrics and Gynecology Department, Faculty of Medicine,
Suez Canal University, Ismailia, Egypt
Sarah Tounsi Department of Obstetrics and Gynecology, Baylor College of
Medicine and Texas Children’s Hospital, Houston, TX, USA
Chapter 1
History of Placenta Accreta Spectrum
Nashwa Anwar Eltaweel and Ahmed Y. Hefnawy
The placenta accreta spectrum is a broad-spectrum pathology related to the abnor-
mally deeply invading and abnormally adherent placental tissues through the uter-
ine wall. Many theories tried to explain the reason behind the pathology; however,
the most popular theory is the destruction of the decidual lining either by the previ-
ous caesareans, curettage, infection, IVF, or myomectomy; simply any disruption of
the endometrial lining can predispose to the deeper implantation of the placenta
through the underlying myometrial layer. The degree of this adherence to or through
the myometrium will further classify the severity of the pathology [1].
With the rising rates of caesarean section deliveries, it is believed that it was
associated with the new emerging pathology “placenta accreta spectrum” despite
lacking strong evidence to support this theory [2]. By searching the literature, we
noted that, in 1885, the first suspected pathologically adherent placenta was
described when Macdonald described a case of a suspected adherent placenta fol-
lowing a prolonged vaginal birth, where some cotyledons were retained intrauterine
following vaginal delivery; the patient was managed conservatively by opiate for
pain control and ergot as an ecbolic to enhance uterine activity. The cotyledons were
retained for days and passed spontaneously as they could not be removed manually;
however, the patient had postpartum sepsis [3].
In 1927, S Foster, from Montreal hospital in Canada, reported “a case of pla-
centa accreta”. The patient had a vaginal breech delivery for a dead fetus. After
delivery, he could not deliver the placenta despite a trial of manual removal under
N. A. Eltaweel (*)
Department of Obstetrics and Gynaecology, University Hospitals of Coventry and
Warwickshire, Coventry, UK
e-mail: [email protected]
A. Y. Hefnawy
Department of Obstetrics and Gynaecology, The Northern Care Alliance NHG group,
Oldham, Manchester, UK
© The Author(s), under exclusive license to Springer Nature 1
Switzerland AG 2023
S. A. Shazly, A. A. Nassr (eds.), Placenta Accreta Spectrum,
https://doi.org/10.1007/978-3-031-10347-6_1
