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

Poster Session 3

Category: Operative Obstetrics

Poster Session 3

(754) Factors associated with performing a cesarean hysterectomy during conservative management attempts for placenta accreta spectrum

Thursday, February 12, 2026
10:30 AM - 12:00 PM  
Objective:
The prevalence of placenta accreta spectrum (PAS) disorders has been increasing over recent decades. Some teams propose conservative management as an alternative to cesarean hysterectomy. Our aim was to examine factors associated with need of a per cesarean hysterectomy while conservative treatment was attempted in cases of PAS.

Study Design:

This was a retrospective, multicenter study (3 centers in France), conducted between January 2013 and December 2023. Included were women who underwent an attempted conservative treatment for PAS. Women with a planned cesarean hysterectomy were excluded. Failure of expected conservative management was defined as the need for a hysterectomy during the same operative session as the cesarean delivery. Attempted conservative treatment were local resection or placenta left in situ partially or completely.



Results:
Among the 101 women included in our study, 72 (71.3%) successfully underwent conservative treatment, while 29 (28.7%) experienced failure, requiring a cesarean hysterectomy. Maternal characteristics were similar between the two groups, except for a higher rate of prior uterine curettage in the failure group (51.7% vs. 25.0%, p = 0.010). Vaginal bleeding during pregnancy (69.0% vs. 38.9%, p = 0.006) and the need for antenatal corticosteroid therapy (69% vs. 43.7%, p = 0.02) were more frequent in the failure group. Intraoperative data showed a trend toward more frequent emergency cesareans in the failure group (41.4% vs. 23.6%, p = 0.074), and more intra operative identification of accreta compared to percreta (75.9% vs. 55.6%, p = 0.088).

Conclusion:
The main risk factor for failure of attempted conservative treatment in cases of PAS is the presence of an history of currrettage and vaginal bleeding during pregnancy. Emergency delivery and intraoperative findings suggestive of accreta may also be associated with failure of conservative treatment.