PLACENTA ACCRETA SPECTRUM: CLINICAL PATHWAY OF A PATIENT IN THE PERINATAL CENTRE OF KYIV

There is no doubt about the danger of obstetric hemorrhage. For many years, the main preventable cause of maternal mortality has been peripartum hemorrhage. Pathology of the placenta – its location and attachment – is one of the main reasons for the development of obstetric hemorrhage, the frequency of which continues to increase, mainly due to the increase in the proportion of abdominal deliveries. For this reason, these conditions receive constant attention from scientists all over the world: there is a constant review of recommendations for the management of pregnant women with these pathologies, as well as the search for the optimal method and timing of delivery to ensure the best health of the mother and the newborn. To date, it has not been possible to reach an unequivocal consensus among diff erent world schools on these issues. Recently, there has been an increase in the number of cases of the placenta growing into the uterine wall – a condition called placenta accreta spectrum, as well as its special form, when the chorionic villi grow into the lower segment of the uterus – placenta previa accreta. These are particularly dangerous conditions that carry a double risk of massive obstetric hemorrhage. The article presents the latest views on the possibilities of organ- preserving surgery for these pathologies and reviews the recommendations of various major world schools of obstetrics and gynecology. We also present our own algorithms for the management and delivery of women withpathologically invasive placenta.