Comments on: Segmental Uterine Wall Resection for Placenta Accreta Spectrum Disorder: For what Purpose? - Revista Brasileira de Ginecologia e Obstetrícia

Comments on: Segmental Uterine Wall Resection for Placenta Accreta Spectrum Disorder: For what Purpose? |

Dear Editor,

I read with great interest the article “Conservative surgical treatment of a case of placenta accreta” by Biyik et al. Although they used the term placenta accreta syndrome to illustrate the condition, the International Federation of Gynecology and Obstetrics (FIGO) recently recommended the use of placenta accreta spectrum (PAS) disorders, which are subclassified into creta, increta, and percreta. While creta is an adhesion abnormality in which the placenta adheres to, but does not invade, the myometrium, increta and percreta are invasion abnormalities, with the placenta invading into and beyond the myometrium, respectively. The terminology of PAS disorder avoids ambiguity, especially regarding the dual meaning of accreta, and I wish to use it in this discussion. Biyik et al partially resected the uterus, with the placenta attaching to it, and then reconstructed it: they performed uterine segmental resection for percreta. It is important to point out that at the time of this procedure, tubal ligation was also performed. My concern regards the combination of segmental resection with tubal ligation.

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