Knowledge Gaps in Placenta Accreta Spectrum

Abstract Since its first description early in the 20th Century, placenta accreta and its variants have changed substantially in incidence, risk factor profile, clinical presentation, diagnosis and management. While systematic use of diagnostic tools and a multidisciplinary team care approach has begun to improve patient outcomes, the condition's pathophysiology, epidemiology, and best practices for diagnosis and management remain poorly understood. The use of large databases with broadly accepted terminology and diagnostic criteria should accelerate research in this area. Future work should focus on non-traditional phenotypes, such as those without placenta previa–preventive strategies, and long term medical and emotional support for patients facing this diagnosis. Key Points Placenta accreta spectrum research may be improved with standardized terminology and use of large databases. Placenta accreta prediction should move beyond ultrasound with the addition of biomarkers, and needs to extend to those without traditional risk factors. Future research should identify practices that can prevent future accreta development.