Strengths and limitations:
Our conservative surgical approach for placenta accreta spectrum disorder has a favourable surgical outcome but does depend on a full understanding of the pathophysiology of the placental condition and the steps required for optimal surgical correction of the myometrial deficiencies. The approach has the strength of conserving the uterus with adequate myometrium thickness, reducing the risks of gynaecological and obstetrical complications later on.
The limitations relate to the need for a comprehensive multidisciplinary team with experience in addressing large blood loss, careful fluid management and anaesthetic input, a practice which may be difficult to achieve in a non-tertiary setting, especially if case numbers are small. In such a situation, a regional network could be beneficial. Our study is also a small series.