Strengths and limitations:
Our conservative surgical approach for placenta accreta spectrum
disorder has a favourable surgical outcome but does depend on a full
understanding of the pathophysiology of the placental condition and the
steps required for optimal surgical correction of the myometrial
deficiencies. The approach has the strength of conserving the uterus
with adequate myometrium thickness, reducing the risks of gynaecological
and obstetrical complications later on.
The limitations relate to the need for a comprehensive multidisciplinary
team with experience in addressing large blood loss, careful fluid
management and anaesthetic input, a practice which may be difficult to
achieve in a non-tertiary setting, especially if case numbers are small.
In such a situation, a regional network could be beneficial. Our study
is also a small series.