The Green Room: A Podcast from Obstetrics & Gynecology June 2025: Placenta Accreta Spectrum- Part 2
May 15, 2025
Join Clarel Antoine, a seasoned obstetrician-gynecologist with a focus on cesarean safety, Yalda Afshar, a physician scientist at UCLA studying the cardiac placental axis, and Lisa Zuckerwise, guest editor on placenta accreta spectrum, for a dive into innovative surgical techniques. They discuss the importance of uterine environment in placentation, explore impactful closure techniques to minimize surgical complications, and emphasize the need for updated guidelines and collaborative research to improve patient outcomes.
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Understanding Normal Placentation
- Normal placentation involves trophoblast cells remodeling maternal spiral arteries to create low resistance, high capacity vessels.
- This transformation ensures adequate blood supply and involves complex interactions with maternal immune cells, a process still not fully understood.
Placenta-Soil Interaction in PAS
- Placenta accreta spectrum (PAS) is better explained by a problem in the uterine environment or 'soil' rather than the placenta itself.
- Absence of decidual regulatory environment and loss of inhibitory signals promote abnormal trophoblast invasion leading to PAS.
Translate Biology to Patient Care
- Understand PAS biology to improve patient risk stratification and early detection.
- Explore therapies and surgical techniques to optimize scar healing and reduce PAS risk after cesarean.
