Overview
This study for the conservative management of placenta accreta spectrum disorders (PAS), which are a major cause of maternal morbidity and mortality. The most common management strategy for PAS in the United States is a preterm cesarean-hysterectomy. However, accumulating data show that conservative management is safer and is preferred by some patients. In selected participants (n=15) who desire uterine preservation, the investigators provide the option of conservative management, which will be defined as leaving the placenta in the uterus after delivery of the infant. This is a single-arm single-site pilot study where all participants will be carefully monitored during a standard postpartum inpatient stay and with outpatient follow-up until the uterus is empty.
Eligibility
Inclusion Criteria:
- Provision of signed and dated informed consent form.
- Stated willingness to comply with all study procedures and availability for the duration of the study.
- A person with a uterus, age 18 or older
- Currently pregnant with an intrauterine gestation or postpartum
- Suspected of having PAS based on history, clinical findings, and/or imaging
- Patients for whom the usual management would be peripartum hysterectomy.
- Patient desires uterine preservation or declines hysterectomy
- Agreement to adhere to Lifestyle Considerations (see section 5.3) throughout study duration.
Exclusion Criteria:
• Have a low antenatal suspicion for PAS based on imaging.
