Maternal Outcomes of Segmental Resection Versus Cesarean Hysterectomy in Placenta Accreta Spectrum: A Retrospective Comparative Study

Background Placenta accreta spectrum (PAS) is a life-threatening obstetric condition associated with significant maternal morbidity and mortality. This study aimed to compare maternal and neonatal outcomes between segmental resection and cesarean hysterectomy in patients with PAS. Methodology This retrospective case-control study included 130 patients diagnosed with PAS between June 2016 and June 2019. Patients were divided into the following two groups: segmental resection (n = 30) and cesarean hysterectomy (n = 100). The choice of surgical technique was determined based on preoperative imaging findings, intraoperative assessment, and the extent of placental invasion. Demographic characteristics, perioperative findings, and maternal and neonatal outcomes were analyzed. Results Patients in the hysterectomy group had significantly higher intraoperative blood loss, longer hospital stay, increased need for blood transfusion, higher rates of bladder injury, longer catheterization duration, and more frequent intensive care unit admission (p < 0.001 for all). No significant differences were observed between groups regarding neonatal outcomes, including gestational age, birth weight, APGAR scores, and neonatal intensive care unit admission. Conclusions Segmental resection appears to be a safe and effective alternative to cesarean hysterectomy in selected PAS cases. However, due to potential selection bias and lack of standardized classification, individualized management based on disease severity and intraoperative findings remains essential. Further prospective studies are needed.