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CME Credit Offered
CME Credit Offered
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Recording available 2/16-5/2
Recording available 2/16-5/2
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Abstract Award
Abstract Award
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Foundation Awardee

Poster Session 1

Category: Clinical Obstetrics

Poster Session 1

(355) Cesarean Delivery Surgical Techniques and Association with Placenta Accreta Spectrum Among Pregnancies with Placenta Previa

Wednesday, February 11, 2026
10:30 AM - 12:00 PM  

    Submitting Author and Presenting Author(s)

  • Sarah T. Mehl, MD (she/her/hers)

    MFM Fellow
    Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston
    Houston, Texas, United States

    • Coauthor(s)

  • Anthony Chartier, MD (he/him/his)

    Resident
    Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston
    Houston, Texas, United States

  • SS

    Sandra Sadek, MD

    Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston
    Houston, Texas, United States

  • EK

    Elias Kassir, MD

    Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston
    Houston, Texas, United States

  • DA

    Diego Aviles, MD

    Division of Gynecology Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston
    Houston, Texas, United States

  • Edgar A. Hernandez-Andrade, MD, PhD (he/him/his)

    Professor
    Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston
    Houston, Texas, United States

  • Megan C. Shepherd, MD (she/her/hers)

    Assistant Professor
    Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston
    Houston, Texas, United States

  • Sean C. Blackwell, MBA, MD

    Professor
    Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston
    Houston, Texas, United States

  • Baha M. Sibai, MD

    Professor
    Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston
    Houston, Texas, United States

  • Farah H. Amro, MD

    Assistant Professor
    Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston
    Houston, Texas, United States

Objective:

The impact of surgical technique for hysterotomy closure during cesarean delivery (CD) and risk of placenta accreta spectrum (PAS) in subsequent pregnancy has not been well studied. Optimal technique to reduce risk of PAS remains unclear. Our objective was to compare surgical technique from antecedent CD between pregnancies with placenta previa alone and previa with PAS.


Study Design:

Retrospective cohort study of pregnancies with placenta previa in the current pregnancy with at least one prior CD from 2016 – 2025 that delivered within our institution’s hospital system. Pregnancies were divided into Group 1: no PAS and Group 2: PAS. Maternal characteristics, antecedent CD surgical technique, delivery complications of the antecedent CD, and current pregnancy outcome of PAS severity by pathology were compared.


Results:

A total of 317 pregnancies with placenta previa were identified with 116 having the antecedent CD operative report available. Maternal characteristics including age, BMI, pre-gestational diabetes, and short interval pregnancy were similar between groups (Table 1). Pregnancies without PAS were more likely to have 1 prior CD (p < 0.02) whereas those with PAS were more likely to have ≥ 3 CD (p < 0.04). Antecedent CD complications including postpartum hemorrhage, intra-amniotic infection, and preterm prelabor rupture of membranes did not differ between groups. Choice of suture and location of uterine incision were similar among both groups. Surgical technique was further evaluated among PAS by severity, with less severe PAS (accreta/increta) having more frequent two-layer closure in the antecedent CD compared to percreta, though not statistically significant (p=0.16) (Figure 1).


Conclusion:

In this cohort of pregnancies with placenta previa, rate of PAS was not changed based on antecedent CD surgical technique or delivery complications. A trend was noted between decreased PAS severity and use of two-layer closure, though not statistically significant. Larger trials are needed to determine the role of single versus double-layer closure in PAS prevention.