Outcome of Conservative Management of Placenta Accreta Spectrum in Mansoura University Hospital

Nasra Hassan Mohamed, DM.B.B.CH in Jazeera University Mogadishu Somalia September 2019 Visitor of Obstetrics and Gynecology Mansoura University Hospital.Follow
Mohamed Mohamed Eltotongy, Professor of Obstetrics and Gynecology, Faculty of Medicine, Mansoura University, Egypt.
Maher Elesewi Kamel Elgaly, Professor of Obstetrics and Gynecology, Faculty of Medicine, Mansoura University, Egypt.

Subject Area

Obstetrics & Gynaecology

Article Type

Original Study

Abstract

Background: Placenta accreta spectrum (PAS) represents a significant global health challenge, with its incidence rising in parallel with the increasing prevalence of cesarean sections (CS). While cesarean hysterectomy is traditionally considered the standard treatment, conservative management offers a fertility-preserving alternative in carefully selected cases. This study aimed to evaluate the safety and effectiveness of conservative treatment for PAS at Mansoura University Hospital over a two-year period.

Methods: This retrospective analytical study included 132 women diagnosed with placenta accreta who underwent conservative management. Patient data, including obstetric history, degree of accreta, bleeding episodes, timing of delivery, and the specific uterine-sparing technique employed, were meticulously analyzed.

Results: The majority of participants presented with Grade I or II placenta accreta, as assessed by both ultrasound and intraoperative examination. A predominantly Type IV placental location and universal hypervascularity were observed. The mean estimated blood loss was 1644.7 ± 643.98 mL, with 9.85% of patients requiring massive transfusion. No organ invasion was noted, bladder dissection was straightforward, and partial placental separation occurred in all cases. Postoperative hemoglobin (Hb) levels showed significant improvement (p < 0.001), and the mean hospital stay was 4.6 ± 0.86 days.

Conclusions: For women with PAS who are carefully selected for uterine-preserving treatment, conservative management proved to be a safe and effective approach. It successfully avoided hysterectomy and major organ injury. The intraoperative blood loss was moderate, only a small proportion necessitated massive transfusion, and all patients experienced a smooth recovery with short hospital stays and improved hemoglobin levels.

Recommended Citation

Mohamed, Nasra Hassan; Eltotongy, Mohamed Mohamed; and Elgaly, Maher Elesewi Kamel (2026) "Outcome of Conservative Management of Placenta Accreta Spectrum in Mansoura University Hospital," Mansoura Medical Journal: Vol. 55 : Iss. 6 , Article 3.
Available at: https://doi.org/10.58775/2735-3990.1539