Uterine Preservation in the Management of Placenta Accreta Spectrum Disorders

University of Pennsylvania15 enrolled

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.

Study Type

INTERVENTIONAL

Allocation

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Placenta Accreta Spectrum

Interventions

Eligibility

Sex: FEMALEMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. Provision of signed and dated informed consent form. 2. Stated willingness to comply with all study procedures and availability for the duration of the study. 3. A person with a uterus, age 18 or older 4. Currently 16-36 weeks pregnant with an intrauterine gestation 5. History of cesarean delivery AND placenta previa OR anterior low-lying placenta AND suspected of having PAS on prenatal imaging (ultrasound/MRI) 6. Patients for whom the usual management would be cesarean-hysterectomy. 7. Patient desires uterine preservation 8. 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.