Conservative management of morbidly adherent placenta: expert review

Am J Obstet Gynecol. 2015 Dec;213(6):755-60. doi: 10.1016/j.ajog.2015.04.034. Epub 2015 Apr 30.


Over the last century, the incidence of placenta accreta, increta, and percreta, collectively referred to as morbidly adherent placenta, has risen dramatically. Planned cesarean hysterectomy at the time of cesarean delivery is the standard recommended treatment in the United States. Recently, interest in conservative management has resurged, especially in Europe. The aims of this review are the following: (1) to provide an overview of methods used for conservative management, (2) to discuss clinical implications for both clinicians and patients, and (3) to identify areas in need of further research.

Keywords: accreta; conservative management; increta; percreta.

Publication types

  • Review

MeSH terms

  • Balloon Occlusion
  • Blood Loss, Surgical / prevention & control
  • Enzyme Inhibitors / therapeutic use
  • Female
  • Humans
  • Hysterectomy
  • Hysteroscopy
  • Ligation
  • Methotrexate / therapeutic use
  • Myometrium / surgery
  • Organ Sparing Treatments*
  • Placenta Accreta / therapy*
  • Placenta, Retained / therapy*
  • Postoperative Hemorrhage / prevention & control
  • Postpartum Hemorrhage / prevention & control
  • Pregnancy
  • Prenatal Diagnosis
  • Time-to-Treatment
  • Uterine Artery / surgery
  • Uterine Artery Embolization


  • Enzyme Inhibitors
  • Methotrexate