Preserve the Uterus For Placenta Accreta Spectrum Overlying Cesarean Scar: a Step-by-step Surgical Technique

Abstract

Surgery for placenta accreta spectrum overlying the cesarean scar is challenging for excessive blood loss. Elective cesarean hysterectomy without disrupting the placenta was the generally accepted approach, however, with high maternal morbidity, loss of fertility and psychological trauma. Innovative approaches are being investigated for uterine preservation. A step-bystep surgical technique was developed in our group and has been used to preserve the uterus in all severe cases with placenta increta/percreta overlying the cesarean scar. The procedure details and the surgical outcomes are provided.