{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T02:48:59Z","timestamp":1791600539675,"version":"4.3.4"},"reference-count":39,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background: Obstetric hysterectomy remains a life-saving intervention for placenta accreta spectrum and uncontrolled obstetric hemorrhage. Evidence regarding the outcomes of planned versus urgent obstetric hysterectomy in contemporary tertiary practice in Greece remains limited. We compared maternal and neonatal outcomes between elective and urgent procedures at a tertiary referral center in Thessaloniki. Methods: We retrospectively reviewed 30 women who underwent obstetric hysterectomy between January 2020 and June 2025. The elective group included women with prenatal PAS diagnosis and planned delivery at \u226534 weeks (n = 17), whereas the urgent group included women requiring unplanned delivery for hemorrhage or active labor without prior surgical preparation (n = 13). Maternal characteristics, intraoperative findings, transfusion requirements, complications, hospital stay, and neonatal outcomes were compared using bivariate statistical tests. Results: Maternal age was similar between groups (36.1 \u00b1 6.1 vs. 37.9 \u00b1 6.8 years; p = 0.44). Elective cases had higher parity (median 3 vs. 1; p = 0.002), had more previous cesarean deliveries (median 2 vs. 0; p = 0.002), and were more frequently diagnosed with placenta previa (p = 0.027). Uterine atony occurred more often in urgent cases (p &lt; 0.001). Bakri balloon tamponade was used only in urgent cases and failed to control hemorrhage (p &lt; 0.001). Operative time, transfusion requirement, hospital stay, and urinary tract injury rates were comparable. No maternal deaths occurred. Birth weight, Apgar scores, and NICU admission rates were also similar. Conclusions: Planned obstetric hysterectomy within a multidisciplinary setting was associated with fewer emergency hemorrhage-control interventions, while major perioperative and neonatal outcomes were comparable between groups.<\/jats:p>","DOI":"10.3390\/jcm15197738","type":"journal-article","created":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T01:40:17Z","timestamp":1791596417000},"page":"7738","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Obstetric Hysterectomy at a Greek Tertiary Referral Center: Differences in Maternal and Neonatal Outcomes Between Elective and Urgent Procedures"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2361-3470","authenticated-orcid":false,"given":"Stefanos","family":"Flindris","sequence":"first","affiliation":[{"name":"2nd Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Faculty of Health Sciences, Medical School, General Hospital of Thessaloniki \u201cIppokratio\u201d, 54642 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"funding-acquisition","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2420-4003","authenticated-orcid":false,"given":"Margioula-Siarkou","family":"Chrysoula","sequence":"additional","affiliation":[{"name":"2nd Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Faculty of Health Sciences, Medical School, General Hospital of Thessaloniki \u201cIppokratio\u201d, 54642 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"project-administration","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3221-7226","authenticated-orcid":false,"given":"Konstantinos","family":"Christopoulos","sequence":"additional","affiliation":[{"name":"Department of Hygiene and Epidemiology, University of Ioannina, Medical School, 45500 Ioannina, Greece"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"software","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"}]},{"given":"Georgia","family":"Margioula-Siarkou","sequence":"additional","affiliation":[{"name":"2nd Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Faculty of Health Sciences, Medical School, General Hospital of Thessaloniki \u201cIppokratio\u201d, 54642 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"}]},{"given":"Ioannis","family":"Chatzikalogiannis","sequence":"additional","affiliation":[{"name":"2nd Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Faculty of Health Sciences, Medical School, General Hospital of Thessaloniki \u201cIppokratio\u201d, 54642 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"}]},{"given":"Michail","family":"Kalinderis","sequence":"additional","affiliation":[{"name":"2nd Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Faculty of Health Sciences, Medical School, General Hospital of Thessaloniki \u201cIppokratio\u201d, 54642 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"}]},{"given":"Alexandros","family":"Traianos","sequence":"additional","affiliation":[{"name":"2nd Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Faculty of Health Sciences, Medical School, General Hospital of Thessaloniki \u201cIppokratio\u201d, 54642 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"}]},{"given":"Elif","family":"Empliouk","sequence":"additional","affiliation":[{"name":"2nd Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Faculty of Health Sciences, Medical School, General Hospital of Thessaloniki \u201cIppokratio\u201d, 54642 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"}]},{"given":"Konstantinos","family":"Pantazis","sequence":"additional","affiliation":[{"name":"2nd Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Faculty of Health Sciences, Medical School, General Hospital of Thessaloniki \u201cIppokratio\u201d, 54642 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0876-5596","authenticated-orcid":false,"given":"Alexandros","family":"Sotiriadis","sequence":"additional","affiliation":[{"name":"1st Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Faculty of Health Sciences, Medical School, General Hospital of Thessaloniki \u201cPapageorgiou\u201d, 56403 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"software","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7144-2840","authenticated-orcid":false,"given":"Konstantinos","family":"Dinas","sequence":"additional","affiliation":[{"name":"2nd Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Faculty of Health Sciences, Medical School, General Hospital of Thessaloniki \u201cIppokratio\u201d, 54642 Thessaloniki, 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Greece"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,10,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e323","DOI":"10.1016\/S2214-109X(14)70227-X","article-title":"Global Causes of Maternal Death: A WHO Systematic Analysis","volume":"2","author":"Say","year":"2014","journal-title":"Lancet Glob. Health"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Mbakwa, M.R., Tendongfor, N., Ngunyi, Y.L., Ngek, E.S.N., Alemkia, F., and Egbe, T.O. (2021). Indications and Outcomes of Emergency Obstetric Hysterectomy; a 5-Year Review at the Bafoussam Regional Hospital, Cameroon. BMC Pregnancy Childbirth, 21.","DOI":"10.1186\/s12884-021-03797-3"},{"key":"ref_3","first-page":"e1","article-title":"Placenta Praevia and Placenta Accreta: Diagnosis and Management: Green-Top Guideline No. 27a","volume":"126","author":"Jauniaux","year":"2019","journal-title":"BJOG"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1097\/AOG.0000000000005022","article-title":"Incidence, Indications, Risk Factors, and Outcomes of Emergency Peripartum Hysterectomy Worldwide: A Systematic Review and Meta-Analysis","volume":"141","author":"Kallianidis","year":"2023","journal-title":"Obstet. Gynecol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"154.e1","DOI":"10.1016\/j.ajog.2007.03.026","article-title":"Planned vs. Emergent Cesarean Hysterectomy","volume":"197","author":"Briery","year":"2007","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1080\/00016340601088448","article-title":"Emergency Obstetric Hysterectomy","volume":"86","author":"Daskalakis","year":"2007","journal-title":"Acta Obstet. Gynecol. Scand."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1111\/1471-0528.12405","article-title":"The Management and Outcomes of Placenta Accreta, Increta, and Percreta in the UK: A Population-Based Descriptive Study","volume":"121","author":"Fitzpatrick","year":"2014","journal-title":"BJOG"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1097\/AOG.0000000000002442","article-title":"Outcomes of Planned Compared With Urgent Deliveries Using a Multidisciplinary Team Approach for Morbidly Adherent Placenta","volume":"131","author":"Shamshirsaz","year":"2018","journal-title":"Obstet. Gynecol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"337.e1","DOI":"10.1016\/j.ajog.2019.05.035","article-title":"Maternal Outcomes in Unexpected Placenta Accreta Spectrum Disorders: Single-Center Experience with a Multidisciplinary Team","volume":"221","author":"Erfani","year":"2019","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1385","DOI":"10.1016\/S0002-9378(99)70023-2","article-title":"Planned Cesarean Hysterectomy: A Preferred Alternative to Separate Operations","volume":"180","author":"Seago","year":"1999","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1515\/JPM.2000.064","article-title":"Peripartum Hysterectomy","volume":"28","author":"Castaneda","year":"2000","journal-title":"J. Perinat. Med."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"El Gelany, S., Ibrahim, E.M., Mohammed, M., Abdelraheim, A.R., Khalifa, E.M., Abdelhakium, A.K., Yousef, A.M., Hassan, H., Goma, K., and Khairy, M. (2019). Management of Bleeding from Morbidly Adherent Placenta during Elective Repeat Caesarean Section: Retrospective -Record -Based Study. BMC Pregnancy Childbirth, 19.","DOI":"10.1186\/s12884-019-2244-4"},{"key":"ref_13","first-page":"e85028","article-title":"Placenta Percreta Previa Crossing Surgical Frontiers","volume":"17","author":"Flindris","year":"2025","journal-title":"Cureus"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"3406","DOI":"10.1245\/s10434-017-6031-z","article-title":"2017 Update on the Querleu\u2013Morrow Classification of Radical Hysterectomy","volume":"24","author":"Querleu","year":"2017","journal-title":"Ann. Surg. Oncol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"235.e1","DOI":"10.1016\/j.ajog.2023.09.099","article-title":"International Expert Consensus on the Surgical Anatomic Classification of Radical Hysterectomies","volume":"230","author":"Querleu","year":"2024","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"American College of Obstetricians and Gynecologists, and Society for Maternal-Fetal Medicine (2018). Obstetric Care Consensus No. 7: Placenta Accreta Spectrum. Obstet. Gynecol., 132, e259\u2013e275.","DOI":"10.1097\/AOG.0000000000002983"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1002\/uog.14952","article-title":"Proposal for Standardized Ultrasound Descriptors of Abnormally Invasive Placenta (AIP)","volume":"47","author":"Collins","year":"2016","journal-title":"Ultrasound Obstet. Gynecol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1590\/0100-3984.2021.0115","article-title":"Magnetic Resonance Imaging Findings in Placenta Accreta Spectrum Disorders: Pictorial Essay","volume":"55","author":"Concatto","year":"2022","journal-title":"Radiol. Bras."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e0315","DOI":"10.1097\/RMR.0000000000000315","article-title":"Magnetic Resonance Imaging Findings of Placenta Accreta Spectrum Disorder: A Pictorial Review","volume":"33","author":"Azouz","year":"2024","journal-title":"Top. Magn. Reson. Imaging"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1002\/ijgo.12761","article-title":"FIGO Classification for the Clinical Diagnosis of Placenta Accreta Spectrum Disorders","volume":"146","author":"Jauniaux","year":"2019","journal-title":"Int. J. Gynecol. Obstet."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1016\/j.bjae.2024.06.005","article-title":"Haemostatic Agents in the Management of Obstetric Haemorrhage","volume":"24","author":"Conwell","year":"2024","journal-title":"BJA Educ."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1226","DOI":"10.1097\/01.AOG.0000219750.79480.84","article-title":"Maternal Morbidity Associated with Multiple Repeat Cesarean Deliveries","volume":"107","author":"Silver","year":"2006","journal-title":"Obstet. Gynecol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1111\/aogs.14120","article-title":"Maternal and Neonatal Outcomes in Planned versus Emergency Cesarean Delivery for Placenta Accreta Spectrum: A Multinational Database Study","volume":"100","author":"Morlando","year":"2021","journal-title":"Acta Obstet. Gynecol. Scand."},{"key":"ref_24","first-page":"1440","article-title":"Emergency Peripartum Hysterectomy: A Comparison of Cesarean and Postpartum Hysterectomy","volume":"190","author":"Forna","year":"2004","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1002\/ijgo.14116","article-title":"FIGO Recommendations on the Management of Postpartum Hemorrhage 2022","volume":"157","author":"Escobar","year":"2022","journal-title":"Int. J. Gynecol. Obstet."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2382","DOI":"10.1038\/s41379-020-0569-1","article-title":"Classification and Reporting Guidelines for the Pathology Diagnosis of Placenta Accreta Spectrum (PAS) Disorders: Recommendations from an Expert Panel","volume":"33","author":"Hecht","year":"2020","journal-title":"Mod. Pathol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1016\/j.ajog.2019.02.054","article-title":"Evidence-Based Guidelines for the Management of Abnormally Invasive Placenta: Recommendations from the International Society for Abnormally Invasive Placenta","volume":"220","author":"Collins","year":"2019","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1002\/ijgo.14121","article-title":"Outcomes in Emergency versus Electively Scheduled Cases of Placenta Accreta Spectrum Disorder Managed by Cesarean-Hysterectomy within a Multidisciplinary Care Team","volume":"159","author":"Chandran","year":"2022","journal-title":"Int. J. Gynecol. Obstet."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1016\/j.ejogrb.2025.01.019","article-title":"Urological Injuries Complicating Pregnancy-Related Hysterectomy: Analysis of Risk Factors and Proposal to Improve the Quality of Care","volume":"306","author":"Orsi","year":"2025","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1111\/ajo.12932","article-title":"The Multidisciplinary Management of Placenta Accreta Spectrum (PAS) within a Single Tertiary Centre: A Ten-Year Experience","volume":"59","author":"Yasin","year":"2019","journal-title":"Aust. N. Z. J. Obstet. Gynaecol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"101432","DOI":"10.1016\/j.ajogmf.2024.101432","article-title":"Emergency Delivery in Pregnancies at High Probability of Placenta Accreta Spectrum on Prenatal Imaging: A Systematic Review and Meta-Analysis","volume":"6","author":"Lucidi","year":"2024","journal-title":"Am. J. Obstet. Gynecol. MFM"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1002\/uog.26299","article-title":"Urological Complications in Women Undergoing Cesarean Section for Placenta Accreta Spectrum Disorders: Systematic Review and Meta-Analysis","volume":"62","author":"Lucidi","year":"2023","journal-title":"Ultrasound Obstet. Gynecol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e28353","DOI":"10.1097\/MD.0000000000028353","article-title":"Emergent versus Planned Delivery in Patients with Placenta Accreta Spectrum Disorders: A Retrospective Study","volume":"100","author":"Thang","year":"2021","journal-title":"Medicine"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1016\/j.jogc.2018.06.020","article-title":"Internal Iliac Artery Balloon Tamponade in Placenta Accreta: Outcomes From the Largest Tertiary Accreta Referral Centre in British Columbia","volume":"41","author":"McGinnis","year":"2019","journal-title":"J. Obstet. Gynaecol. Can."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Kostov, S., Kornovski, Y., Slavchev, S., Ivanova, Y., Aleksandrova, E., Georgieva, S., Selcuk, I., Wafa, M., Hasan, I., and Yordanov, A. (2026). Proximal Internal Iliac Artery Ligation in Obstetrics and Gynecology: An 11-Year Retrospective Single-Center Experience with No Clinically Detected Ischemic Complications. J. Clin. Med., 15.","DOI":"10.3390\/jcm15145658"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1080\/14767058.2020.1716715","article-title":"Placenta Accreta Spectrum: A Hysterectomy Can Be Prevented in Almost 80% of Cases Using a Resective-Reconstructive Technique","volume":"35","author":"Fiorillo","year":"2022","journal-title":"J. Matern. Fetal. Neonatal Med."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1016\/j.ajog.2025.01.030","article-title":"Conservative Management of Placenta Accreta Spectrum Is Associated with Improved Surgical Outcomes Compared to Cesarean Hysterectomy: A Systematic Review and Meta-Analysis","volume":"232","author":"Hessami","year":"2025","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"3161","DOI":"10.1007\/s43032-021-00824-8","article-title":"Intraoperative Cell Salvage for Women at High Risk of Postpartum Hemorrhage During Cesarean Section: A Systematic Review and Meta-Analysis","volume":"29","author":"Obore","year":"2022","journal-title":"Reprod. Sci."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"175.e1","DOI":"10.1016\/j.ajog.2021.03.014","article-title":"The Modified Radical Peripartum Cesarean Hysterectomy (Soleymani-Alazzam-Collins Technique): A Systematic, Safe Procedure for the Management of Severe Placenta Accreta Spectrum","volume":"225","author":"Collins","year":"2021","journal-title":"Am. J. Obstet. Gynecol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/19\/7738\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T01:55:04Z","timestamp":1791597304000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/19\/7738"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,8]]},"references-count":39,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2026,10]]}},"alternative-id":["jcm15197738"],"URL":"https:\/\/doi.org\/10.3390\/jcm15197738","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,8]]}}}