{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T18:45:14Z","timestamp":1792176314230,"version":"4.4.0"},"reference-count":31,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate the association between serum markers and successful conservative management of patients with placenta accreta spectrum (PAS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a retrospective case\u2013control study where patients with high\u2010grade PAS between 2011 and 2025 undergoing conservative leaving the placenta in\u00a0situ were included. The management followed the Frankfurt PAS Procedure where the placenta was left in\u00a0situ after cesarean section (CS) followed by uterine artery embolization and two\u2010step surgery. Regular laboratory investigations included the assessment of serum markers including beta human chorionic gonadotropin (\u03b2\u2010hCG), serum placental growth factor (PlGF), progesterone, and pregnancy\u2010associated plasma protein A (PAPP\u2010A). Mixed effects models with random intercept were utilized to assess the association between the marker levels and uterine preservation over follow\u2010up time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The study included 24 women, seven of which with successful uterine preservation had lower \u03b2\u2010hCG, PlGF and progesterone with medians of 1469 (282.2, 5532), 117 (27.2, 258), and 24.5 (4.2, 66) compared to the 17 needing hysterectomy with medians of 9041 (3563, 16\u2009824), 227.2 (129, 368), and 60 (47, 83), respectively, but no difference in PAPP\u2010A levels. The mixed effects models showed a decline for \u03b2\u2010hCG, PAPP\u2010A, progesterone over time (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001), but not for PlGF. The rate of \u03b2\u2010hCG drop was higher for patients with preserved uterus especially within the first two weeks of follow\u2010up with a coefficient of 311 mIU\/mL per day.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\u03b2\u2010hCG, PlGF and progesterone levels successively decrease after conservative PAS management, and there is a negative association between successful uterine retention and serum \u03b2\u2010hCG levels. The optimal window for performing a two\u2010step surgery might be 2\u20133\u2009weeks post CS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.71113","type":"journal-article","created":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T15:28:56Z","timestamp":1780327736000},"page":"895-901","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The utility of serum markers in the conservative management of placenta accreta spectrum (\n                    <scp>PAS<\/scp>\n                    ) by leaving the placenta in\u00a0situ in women with high\u2010grade\n                    <scp>PAS<\/scp>"],"prefix":"10.1002","volume":"175","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5345-4688","authenticated-orcid":false,"given":"Ammar","family":"Al Naimi","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Prenatal Medicine Goethe\u2010University Hospital  Frankfurt 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