Objectives: Placenta accreta spectrum (PAS) significantly complicates childbirth and often involves urologic organs. Multidisciplinary team (MDT) care is crucial for optimal outcomes. This study aimed to evaluate urologic interventions in PAS patients at a centralised, tertiary referral centre.
Methods: An analysis was conducted on prospectively collected data from women presenting with PAS at the institution between November 2013 and June 2019. Patients requiring urological intervention were identified, and perioperative details were retrieved.
Results:
- Cases Identified: 42
- Mean Maternal Age: 35 years
- Mean Gestational Age at Delivery: 34 weeks
- Management:
- 37 cases managed electively
- 5 cases managed conservatively (no hysterectomy)
- 5 cases required emergency managemen
- Urologic Interventions:
- 15 patients (36%) had suspected bladder invasion on MRI
- 36 patients (86%) had ureteric catheters inserted
- 14 patients (33%) required bladder repair
- 2 patients (5%) had ureteric injuries
Conclusions: PAS often necessitates urological intervention to prevent and repair bladder and ureter injuries. This rare condition is best managed by an MDT in a centralised, high-volume tertiary centre with access to various medical and surgical sub-specialties.
