A placenta accreta spectrum review: focusing on antenatal care and surgical approach

<h2>Abstract</h2> The primary risk factor for a morbidly adherent placenta (placenta accreta spectrum) is a previous caesarean birth. It is estimated that by 2030 28.5% of births worldwide will be performed by caesarean birth. The extensive remodelling which the lower uterine segment undergoes post caesarean birth causes disruption of the normal histological boundaries between uterus and a low-lying placenta in any subsequent pregnancy. We know that placenta accreta spectrum (PAS) is a condition which carries a high risk of maternal morbidity and mortality. There is a limited amount of research concerning PAS and there is wide variation in the management worldwide. This article aims to summarize current guidance and research, whilst introducing exciting areas of research, discussion and debate; it will focus on antenatal care, diagnosis, surgical staging and the surgery itself.