OP68 Placenta accreta spectrum (PAS): data review of PAS cases successfully managed by a trained multidisciplinary team in our tertiary referral hospital

<h3>Background and Aims</h3> Placenta accreta spectrum (PAS), is frequently associated with severe obstetric haemorrhage, anaesthesia risks and high mortality. We present a data review of PAS cases successfully managed by a trained, comprehensive, multidisciplinary team in an Italian Tertiary referral hospital. <h3>Methods</h3> The analysis includes all PAS cases which have been managed between 2020 and 1st semester of 2024 at Casa Sollievo della Sofferenza (CSS), city of San Giovanni Rotondo, Italy <h3>Results</h3> During the study period, 19 women underwent Caesarean Section for PAS-related reasons. More than half women were preterm at time of delivery and almost 100% had almost one previous caesarean section (CS) in their obstetric history. Regarding Obstetric management during pregnancy, 66.7% were placenta praevia major cases. MRI was performed in 3 cases. Regarding Multidisciplinary management at time of delivery, almost half CS were performed in Hybrid Operating Room; more than half were conducted under Regional Anaesthesia and for all of them interventional radiologic procedures with preoperative placement of catheters were carried out; iliac arteries occlusion was necessary for half of them. Ureteral stents were placed in 2 cases. Peripartum Hysterectomy was performed in 4 cases and one third of them were admitted to the ICU. More than half newborns were admitted to the NICU. No maternal or neonatal deaths occurred. <h3>Conclusions</h3> CSS has developed an internal protocol for managing PAS cases. We presented our cases successfully managed by a trained, comprehensive, multidisciplinary team, composed of Gynaecologists, Obstetricians, Sonographers, Anaesthesiologists, Urologists and Interventional Radiologists. A careful antepartum diagnosis by ultrasound imaging is critical to get ready for surgery; surgical and anaesthetic skills are significant to reduce risk of injury; interventional radiologic technique is fundamental to minimise high risk of intraoperative haemorrhage. These skilled facilities are fundamental for optimal management of these increasingly frequent cases.