Outcomes of subsequent pregnancies following modified one-step conservative uterine surgery (MOSCUS) in the management of placenta accreta spectrum: Two case reports and a narrative review of the literature
Year: 2026
Type: review
Abstract: Cesarean hysterectomy is a common management approach for placenta accreta spectrum. While conservative uterine management can preserve fertility, outcome data remain limited. This article reports the long-term results of modified one-step conservative uterine surgery (MOSCUS) in two cases of placenta accreta spectrum and reviews the literature on the outcomes of subsequent pregnancies after conservative management of the condition. Two women with a history of placenta accreta spectrum managed with MOSCUS attended a tertiary referral hospital in southern Vietnam with term and near-term pregnancies. The pregnancy outcomes were favorable with elective cesarean delivery. Neither uterine rupture nor recurrent placenta accreta spectrum was observed. The low uterine segment of the myometrial layer was 1–1.5 cm in thickness. The mothers and neonates were discharged uneventfully. The data relating to the subsequent pregnancy outcomes after conservative management reported in the literature spanning 2020–2025 are limited and heterogeneous. Commonly, the materno-fetal outcomes are favorable. The recurrence of placenta accreta spectrum in late pregnancy ranges from 5.5 % to 22.7 %. The major concerns are the increased rate of cesarean section and postpartum hemorrhage. In conclusion, the MOSCUS is a promising method that preserves fertility. A well-resourced antenatal care system with a multidisciplinary team is needed to manage these high-risk pregnancies. Further data are required to strengthen these findings. • Placenta accreta spectrum renders subsequent pregnancies high risk and appropriate antenatal care is important. • The major concerns in women with placenta accreta spectrum are the increased rate of cesarean section and postpartum hemorrhage. • The data relating to the pregnancy outcomes of women with placenta accreta spectrum after conservative management are limited. • Modified one-step conservative uterine surgery (MOSCUS) is an appropriate approach to the management of placenta accreta spectrum. • MOSCUS can preserve fertility.
Source: Case Reports in Women s Health
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,080
OpenAlex ID: W7118183133