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A randomized controlled study comparing two uterine sparing techniques in conservative management of placenta accreta spectrum.

OBJECTIVES
To compare the efficacy and safety of two uterine sparing techniques in conservative management of placenta accreta spectrum (PAS).


METHODS
This multi-center randomized controlled study was conducted from January 1, 2017, to December 31, 2020, at two university hospitals. Patients were randomly allocated into 2 groups; Group 1 was managed by Assar's technique, and Group 2 was operated by Shehata's technique. Operative time, blood loss, operative complications (organ or vessel injury), and postoperative complications (early and late) were reported. Success of the technique, units of blood transfusion, and intensive care unit (ICU) admissions were recorded.


RESULTS
Demographic data in both groups were non-significantly different. The mean gestational age at the delivery time was 36 weeks in both groups. Operative time was 120 (100-140) minutes and 75 (60-100) minutes in Assar's and Shehata's techniques, respectively (p <0.001). Blood loss was higher in Shehata's technique than in Assar's (p <0.001). ICU admissions were minimal in both groups. Operative complications were comparable in both groups. The success of Assar's and Shehata's techniques in uterine preservation was 85% and 95%, respectively.


CONCLUSION
Both techniques were safe and successful in uterine sparing. Therefore, we recommend these techniques for conservative management of PAS.