{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T15:51:11Z","timestamp":1789487471905,"version":"build-2803163510"},"reference-count":80,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:00:00Z","timestamp":1783900800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:00:00Z","timestamp":1783900800000},"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":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Placenta accreta spectrum (PAS) disorders are associated with substantial maternal morbidity and remain one of the most challenging conditions in modern obstetrics. Although cesarean hysterectomy with the placenta left in\u00a0situ is widely regarded as the standard treatment, uterus\u2010preserving surgical strategies have emerged as viable alternatives in carefully selected cases managed in specialized centers. Building on our recently published systematic review and meta\u2010analysis, this expert\u2010illustrated review provides a comprehensive and critical appraisal of conservative surgical approaches for PAS, with a particular focus on operative techniques, patient selection, and short\u2010 and long\u2010term outcomes. We clearly differentiate two fundamentally distinct conservative strategies: myometrial resection techniques and leaving the placenta in\u00a0situ. For each approach, we synthesize current evidence, describe procedural nuances, highlight technical prerequisites, and discuss expected intraoperative and delayed complications. The most commonly performed myometrial resection techniques\u2014including one\u2010step conservative surgery, the Triple\u2010P procedure, and the Kasr Alainy technique\u2014are detailed step\u2010by\u2010step and illustrated to emphasize key surgical principles. Expectant management with the placenta left in\u00a0situ is also reviewed, with particular attention to indications, postoperative surveillance, delayed morbidity, and fertility outcomes. Data from 50 studies encompassing 2659 patients undergoing myometrial resection and 552 managed with the placenta left in\u00a0situ are integrated to contextualize reported outcomes and failure rates. This expert review aims to support clinical decision\u2010making by clarifying the indications, limitations, and risks of conservative PAS management. We argue that uterus\u2010preserving strategies can be safely and effectively implemented in selected patients when performed by experienced multidisciplinary teams, while emphasizing that readiness to convert to hysterectomy remains essential. By distinguishing techniques and aligning them with patient\u2010specific factors, this review provides practical guidance for maternal\u2013fetal medicine specialists managing PAS in contemporary clinical practice.<\/jats:p>","DOI":"10.1111\/aogs.70291","type":"journal-article","created":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T14:40:09Z","timestamp":1783953609000},"page":"1932-1949","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Uterus\u2010preserving surgery for placenta accreta spectrum: An\u00a0expert, illustrated review of techniques and its outcomes"],"prefix":"10.1111","volume":"105","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8464-6594","authenticated-orcid":false,"given":"Pedro","family":"Viana Pinto","sequence":"first","affiliation":[{"name":"Servi\u00e7o de Ginecologia ULS S\u00e3o Jo\u00e3o  Porto Portugal"},{"name":"Departamento de Anatomia Faculdade de Medicina da Universidade do Porto  Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albaro Jos\u00e9","family":"Nieto\u2010Calvache","sequence":"additional","affiliation":[{"name":"Departamento de Ginecolog\u00eda y Obstetricia Fundaci\u00f3n Valle del Lili  Cali Colombia"},{"name":"Universidad ICESI Facultad de Ciencias de la Salud  Cali Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1834-3055","authenticated-orcid":false,"given":"Rafael Jos\u00e9","family":"Vieira","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine University of Porto  Porto Portugal"},{"name":"Centre for Health Technology and Services Research, Health Research Network (CINTESIS@RISE), Faculty of Medicine University of Porto  Porto 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