{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T14:32:49Z","timestamp":1786717969741,"version":"build-2736575974"},"reference-count":60,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T00:00:00Z","timestamp":1772496000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>This narrative review presents an updated overview of the etiology, pathophysiology, diagnostic approaches, and management strategies for Placenta Accreta Spectrum (PAS), with emphasis on clinical implications and current gaps in evidence. PAS is associated with substantial maternal morbidity and mortality, with reported maternal mortality rates approaching 7%. Affected patients often experience prolonged hospitalization, repeated surgical interventions, and long-term psychological and emotional consequences. The development of PAS is primarily attributed to impaired decidualization in areas of uterine scarring, resulting in abnormal adherence or invasion of chorionic villi into the myometrium. Optimal outcomes in high-risk pregnancies depend on early antenatal identification using characteristic pathological and imaging findings. Current evidence supports planned cesarean hysterectomy as the safest and most definitive treatment for most patients, whereas conservative and uterus-preserving approaches should be reserved for carefully selected cases managed in specialized centers. Further progress in PAS management requires standardized diagnostic criteria, prospective evaluation of conservative strategies, and improved access to multidisciplinary expertise.<\/jats:p>","DOI":"10.3390\/diagnostics16050760","type":"journal-article","created":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T16:18:45Z","timestamp":1772554725000},"page":"760","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Placenta Accreta Spectrum: Diagnostic Challenges and Management Strategies"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-7643-5879","authenticated-orcid":false,"given":"Zlatko","family":"Kirovakov","sequence":"first","affiliation":[{"name":"Faculty for Public Health and Healthcare, Burgas State University Prof. Dr. Assen Zlatarov, 8010 Burgas, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7719-382X","authenticated-orcid":false,"given":"Angel","family":"Yordanov","sequence":"additional","affiliation":[{"name":"Department of Gynecologic Oncology, Medical University Pleven, 5800 Pleven, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Tsoneva","sequence":"additional","affiliation":[{"name":"Department of Reproductive Medicine, Specialized Hospital for Active Treatment of Obstetrics and Gynaecology \u201cDr Shterev\u201d, 1330 Sofia, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Chen, Q., Shen, K., Wu, Y., Wei, J., Huang, J., and Pei, C. 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