About this Research Topic
Although highly variable in incidence ranging from a high of 1:111 pregnancies to a low of 1:93,000, abnormally invasive placentation resulting in placenta accreta spectrum (PAS) is increasing and correlates with the increasing rate of cesarean delivery. PAS appears more commonly when placentation occurs at the region of the cesarean scar, where the decidua basalis structure and function can be disrupted, allowing the placenta to invade the myometrium. It is the myometrial invasion by the placenta that prevents its usual separation as an intact structure after delivery.
Antenatal identification of invasive placentation in women with PAS allows for better management, planned surgery, and improved maternal and perinatal outcomes. Antenatal diagnosis is based on ultrasound using the Placenta Accreta Index, a standardized approach using ultrasound and clinical risk for prenatal diagnosis of PAS, followed by confirmation by magnetic resonance imaging (MRI) for findings of an abnormally invasive placenta.
The current management for PAS includes both conservative uterine-sparing approaches and hysterectomy. Conservative strategies that can potentially preserve future fertility options for the patient have met with varying degrees of success. The uterine-sparing strategy consists of leaving the placenta in situ during cesarean delivery without a hysterectomy. The hysterectomy approach consists of leaving the placenta in situ during cesarean delivery and proceeding with hysterectomy immediately after the infant is born.
This Research Topic will focus on abnormally invasive placenta with particular emphasis on antenatal diagnosis, bladder invasion, and surgical approach. The goal is to publish recent advances on the topic.
This Research Topic will include (but is not limited to):
• antenatal diagnosis of placenta accreta spectrum by ultrasound and MRI
• features of bladder invasion
• surgical approaches to placenta accreta spectrum
• criteria for the center of excellence for managing placenta accreta spectrum
• features of placenta accreta spectrum such as scar pregnancy, cesarean scar defect, and postpartum hemorrhage
Randomized Controlled Trials (RCTs), reviews, meta-analyses, cohort studies, and case reports, are welcome.
Antenatal identification of invasive placentation in women with PAS allows for better management, planned surgery, and improved maternal and perinatal outcomes. Antenatal diagnosis is based on ultrasound using the Placenta Accreta Index, a standardized approach using ultrasound and clinical risk for prenatal diagnosis of PAS, followed by confirmation by magnetic resonance imaging (MRI) for findings of an abnormally invasive placenta.
The current management for PAS includes both conservative uterine-sparing approaches and hysterectomy. Conservative strategies that can potentially preserve future fertility options for the patient have met with varying degrees of success. The uterine-sparing strategy consists of leaving the placenta in situ during cesarean delivery without a hysterectomy. The hysterectomy approach consists of leaving the placenta in situ during cesarean delivery and proceeding with hysterectomy immediately after the infant is born.
This Research Topic will focus on abnormally invasive placenta with particular emphasis on antenatal diagnosis, bladder invasion, and surgical approach. The goal is to publish recent advances on the topic.
This Research Topic will include (but is not limited to):
• antenatal diagnosis of placenta accreta spectrum by ultrasound and MRI
• features of bladder invasion
• surgical approaches to placenta accreta spectrum
• criteria for the center of excellence for managing placenta accreta spectrum
• features of placenta accreta spectrum such as scar pregnancy, cesarean scar defect, and postpartum hemorrhage
Randomized Controlled Trials (RCTs), reviews, meta-analyses, cohort studies, and case reports, are welcome.
Keywords: Placenta accreta, postpartum hemorrhage, urology, obstertrics, surgery
Important Note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.
