A recent study led by researchers at UTHealth Houston suggests that leaving the placenta in place after childbirth could be a safer alternative to immediate surgery for women with placenta accreta spectrum (PAS). This condition, which is rare but serious, involves the placenta attaching too deeply to the uterine wall and can cause severe bleeding during childbirth. Traditionally, PAS has been treated with a cesarean hysterectomy immediately after delivery, but this procedure carries significant risks such as heavy blood loss and infection.
Farah Amro, MD, an assistant professor at McGovern Medical School at UTHealth Houston and medical director of the PAS Program there, tested an alternative approach. The method involves leaving the placenta in place post-delivery to allow it to be absorbed naturally or performing a delayed hysterectomy when conditions are safer. "The traditional treatment for PAS has been cesarean hysterectomy; however, the procedure carries high risks," Amro stated. "In our study...we found that when the placenta is left under careful monitoring, patients experienced less blood loss and required fewer transfusions."
Amro's team studied 180 patients diagnosed with PAS between January 2015 and December 2024. In 43 cases, they left the placenta in place; among these women, some planned to keep their uterus while others opted for delayed hysterectomies. Thirteen cases were successful with natural breakdown over about 17 weeks. Five women later had healthy pregnancies without complications related to PAS.
"Given the rarity of PAS, our findings are significant and offer women hope and increased options," Amro noted. She emphasized further research is needed to identify suitable candidates for this approach and called for larger studies with standardized protocols.
"Our study is just the beginning...for continued exploration into safer...treatment options for women with PAS," Amro added.
