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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">akusherstvo</journal-id><journal-title-group><journal-title xml:lang="en">Obstetrics, Gynecology and Reproduction</journal-title><trans-title-group xml:lang="ru"><trans-title>Акушерство, Гинекология и Репродукция</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2313-7347</issn><issn pub-type="epub">2500-3194</issn><publisher><publisher-name>IRBIS LLC</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.17749/2313-7347/ob.gyn.rep.2024.571</article-id><article-id custom-type="elpub" pub-id-type="custom">akusherstvo-2258</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>REVIEW ARTICLES</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>НАУЧНЫЕ ОБЗОРЫ</subject></subj-group></article-categories><title-group><article-title>Current state of the placenta accreta spectrum issue: prospects for organ-preserving treatment</article-title><trans-title-group xml:lang="ru"><trans-title>Современное состояние вопроса placenta accreta spectrum: перспективы органосохраняющего лечения</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0008-7178-3969</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Воронина</surname><given-names>М. Д.</given-names></name><name name-style="western" xml:lang="en"><surname>Voronina</surname><given-names>M. D.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Воронина Марьяна Дмитриевна </p><p>344022 Ростов-на-Дону, Нахичеванский переулок, д. 29</p></bio><bio xml:lang="en"><p>Maryana D. Voronina</p><p>29 Nahichevansky Lane, Rostov-on-Don 344022</p></bio><email xlink:type="simple">voronina-maryana@list.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0007-4659-3672</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Долгиев</surname><given-names>Д. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Dolgiev</surname><given-names>D. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Долгиев Джамалейл Алиханович </p><p>344022 Ростов-на-Дону, Нахичеванский переулок, д. 29</p></bio><bio xml:lang="en"><p>Dzhamaleyl A. Dolgiev</p><p>29 Nahichevansky Lane, Rostov-on-Don 344022</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0000-7245-0201</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Долгиева</surname><given-names>Р. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Dolgieva</surname><given-names>R. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Долгиева Раисхан Алихановна</p><p>344022 Ростов-на-Дону, Нахичеванский переулок, д. 29</p></bio><bio xml:lang="en"><p>Raiskhan A. Dolgieva</p><p>29 Nahichevansky Lane, Rostov-on-Don 344022</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0000-2056-2690</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Мироваева</surname><given-names>А. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Mirovaeva</surname><given-names>A. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Мироваева Анастасия Сергеевна </p><p>344022 Ростов-на-Дону, Нахичеванский переулок, д. 29</p></bio><bio xml:lang="en"><p>Anastasiya S. Mirovaeva</p><p>29 Nahichevansky Lane, Rostov-on-Don 344022</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0009-4528-790X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Гараева</surname><given-names>З. Ф.</given-names></name><name name-style="western" xml:lang="en"><surname>Garaeva</surname><given-names>Z. F.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Гараева Залия Фаритовна </p><p>426056 Ижевск, ул. Коммунаров, д. 281</p></bio><bio xml:lang="en"><p>Zaliya F. Garaeva</p><p>281 Kommunarov Str., Izhevsk 426056</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0003-2453-6934</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Иванова</surname><given-names>Ю. К.</given-names></name><name name-style="western" xml:lang="en"><surname>Ivanova</surname><given-names>Yu. K.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Иванова Юлия Константиновна</p><p>197022 Санкт-Петербург, ул. Льва Толстого, д. 6–8</p></bio><bio xml:lang="en"><p>Yulia K. Ivanova</p><p>6–8 Lev Tolstoy Str., Saint Petersburg 197022</p></bio><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0004-1532-9949</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Сарапульцев</surname><given-names>И. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Sarapultsev</surname><given-names>I. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Сарапульцев Илья Владимирович</p><p>610027 Киров, ул. Карла Маркса, д. 112</p></bio><bio xml:lang="en"><p>Ilya V. Sarapultsev</p><p>112 Karl Marks Str., Kirov 610027</p></bio><xref ref-type="aff" rid="aff-4"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0007-0171-8961</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Турдиева</surname><given-names>Е. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Turdieva</surname><given-names>E. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Турдиева Елизавета Игоревна</p><p>344022 Ростов-на-Дону, Нахичеванский переулок, д. 29</p></bio><bio xml:lang="en"><p>Elizaveta I. Turdieva</p><p>29 Nahichevansky Lane, Rostov-on-Don 344022</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0005-8888-0501</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Раков</surname><given-names>В. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Rakov</surname><given-names>V. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Раков Владимир Андреевич</p><p>191015, Санкт-Петербург, ул. Кирочная, д. 41</p></bio><bio xml:lang="en"><p>Vladimir A. Rakov</p><p>41 Kirochnaya Str., Saint Petersburg 191015</p></bio><xref ref-type="aff" rid="aff-5"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0006-9782-6969</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Куклина</surname><given-names>В. К.</given-names></name><name name-style="western" xml:lang="en"><surname>Kuklina</surname><given-names>V. K.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Куклина Вероника Константиновна</p><p>191015, Санкт-Петербург, ул. Кирочная, д. 41</p></bio><bio xml:lang="en"><p>Veronika K. Kuklina</p><p>41 Kirochnaya Str., Saint Petersburg 191015</p></bio><xref ref-type="aff" rid="aff-5"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0009-7892-4768</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Манелов</surname><given-names>А. Е.</given-names></name><name name-style="western" xml:lang="en"><surname>Manelov</surname><given-names>A. E.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Манелов Александр Евгеньевич</p><p>191015, Санкт-Петербург, ул. Кирочная, д. 41</p></bio><bio xml:lang="en"><p>Aleksandr E. Manelov</p><p>41 Kirochnaya Str., Saint Petersburg 191015</p></bio><xref ref-type="aff" rid="aff-5"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0004-7365-9428</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Халилова</surname><given-names>К. Х.</given-names></name><name name-style="western" xml:lang="en"><surname>Khalilova</surname><given-names>K. Kh.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Халилова Кифаят Хаял кызы</p><p>443099 Самара, ул. Чапаевская, д. 89</p></bio><bio xml:lang="en"><p>Kifayat Kh. Khalilova</p><p>89 Chapaevskaya Str., Samara 443099</p></bio><xref ref-type="aff" rid="aff-6"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБОУ ВО «Ростовский государственный медицинский университет» Министерства здравоохранения Российской Федерации</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Rostov State Medical University, Ministry of Health of the Russian Federation</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>ФГБОУ ВО «Ижевская государственная медицинская академия» Министерства здравоохранения Российской Федерации</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Izhevsk State Medical Academy, Ministry of Health of the Russian Federation</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>ФГБОУ ВО «Первый Санкт-Петербургский государственный медицинский университет имени И.П. Павлова» Министерства здравоохранения Российской Федерации</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Pavlov First Saint Petersburg State Medical University, Ministry of Health of the Russian Federation</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-4"><aff xml:lang="ru"><institution>ФГБОУ ВО «Кировский государственный медицинский университет» Министерства здравоохранения Российской Федерации</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Kirov State Medical University, Ministry of Health of the Russian Federation</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-5"><aff xml:lang="ru"><institution>ФГБОУ ВО «Северо-Западный государственный медицинский университет имени И.И. Мечникова» Министерства здравоохранения Российской Федерации</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Mechnikov North-Western State Medical University, Ministry of Health of the Russian Federation</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-6"><aff xml:lang="ru"><institution>ФГБОУ ВО «Самарский государственный медицинский университет» Министерства здравоохранения Российской Федерации</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Samara State Medical University, Ministry of Health of the Russian Federation</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>27</day><month>11</month><year>2024</year></pub-date><volume>19</volume><issue>1</issue><fpage>82</fpage><lpage>96</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Voronina M.D., Dolgiev D.A., Dolgieva R.A., Mirovaeva A.S., Garaeva Z.F., Ivanova Y.K., Sarapultsev I.V., Turdieva E.I., Rakov V.A., Kuklina V.K., Manelov A.E., Khalilova K.K., 2025</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="ru">Воронина М.Д., Долгиев Д.А., Долгиева Р.А., Мироваева А.С., Гараева З.Ф., Иванова Ю.К., Сарапульцев И.В., Турдиева Е.И., Раков В.А., Куклина В.К., Манелов А.Е., Халилова К.Х.</copyright-holder><copyright-holder xml:lang="en">Voronina M.D., Dolgiev D.A., Dolgieva R.A., Mirovaeva A.S., Garaeva Z.F., Ivanova Y.K., Sarapultsev I.V., Turdieva E.I., Rakov V.A., Kuklina V.K., Manelov A.E., Khalilova K.K.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.gynecology.su/jour/article/view/2258">https://www.gynecology.su/jour/article/view/2258</self-uri><abstract><sec><title>Introduction</title><p>Introduction. Placenta accreta spectrum (PAS) is the preferred term approved by most international organizations that refers to the range of pathologic adherence of the placenta. PAS is a serious problem with incidence rate of 1/272 in-labor women. Today, peripartal hysterectomy is considered as the generally accepted global practice for PAS management, however, this approach is related to high level of maternal mortality and the impossibility of pregnancy in the future.</p></sec><sec><title>Aim</title><p>Aim: to analyze publications on the available methods for PAS diagnostics and management by highlighting organ-preserving treatment including assessment of relevant risks and benefits compared with other methods as well as prospects for patients.</p></sec><sec><title>Materials and Methods</title><p>Materials and Methods. Research papers were searched for in the databases eLibrary, PubMed and Google Scholar released until August 2024. The following search queries were used: "placenta accreta spectrum", "PAS", "PAS and organ-preserving treatment", "PAS and peripartum hysterectomy", "PAS and organ-preserving management". The selection of articles was carried out in accordance with the recommendations of PRISMA initiative that allowed to analyze 75 publications included in the review.</p></sec><sec><title>Results</title><p>Results. Organ-preserving PAS treatment is a reasonable alternative to peripartal hysterectomy, because it provides better results with lower risk to maternal health. It is worth noting that each of these methods has own unique features. For instance, organpreserving treatment may last longer to achieve a desired result, but at the same time it can reduce a risk of complications and improve a woman's quality of life in the long term. Along with this, peripartal hysterectomy may be more effective in the short term, but it is associated with a higher risk of complications.</p></sec><sec><title>Conclusion</title><p>Conclusion. A doctor should provide a woman with all the necessary information about the risks and benefits of each method, as well as help a woman make an informed decision based on her individual needs and preferences. Organ-preserving PAS treatment contributing to preserve fertility offers a better quality of life with lower risk to maternal health. Ultimately, a choice between peripartal hysterectomy and organ-preserving treatment depends on a specific situation as well as woman's state of health.</p></sec></abstract><trans-abstract xml:lang="ru"><sec><title>Введение</title><p>Введение. Предпочтительным термином, одобренным большинством международных организаций, для определения аномальной плацентации всех степеней инвазии является placenta accreta spectrum (PAS). PAS – это серьезная проблема, которая встречается у одной женщины из 272 рожениц. На сегодняшний день общепринятой мировой практикой ведения PAS является перипартальная гистерэктомия, однако этот подход связан с высоким уровнем материнской смертности и невозможностью беременности в будущем.</p></sec><sec><title>Цель</title><p>Цель: проанализировать литературные данные, посвященные имеющимся методам диагностики и ведения PAS с акцентом на органосохраняющее лечение, включая оценку его рисков и преимуществ по сравнению с другими методами, а также перспективы для пациенток.</p></sec><sec><title>Материалы и методы</title><p>Материалы и методы. Поиск научных работ проводился в базах данных еLibrary, PubMed и Google Scholar до августа 2024 г. Для поиска использовались следующие поисковые термины на русском и английском языках: «placenta accreta spectrum», «PAS», «PAS и органосохраняющее лечение», «PAS и перипартальная гистерэктомия», «PAS и органосохраняющее ведение», «PAS and organ-preserving treatment», «PAS and peripartum hysterectomy», «PAS and organ-preserving management». Отбор статей осуществлялся в соответствии с рекомендациями PRISMA. В итоге в обзор были включены 75 публикаций.</p></sec><sec><title>Результаты</title><p>Результаты. Органосохраняющее лечение PAS является разумной альтернативой перипартальной гистерэктомии, так как обеспечивает лучшие результаты с меньшим риском для здоровья матери. Стоит отметить, что каждый из этих методов имеет свои уникальные особенности. Так, органосохраняющее лечение может потребовать больше времени для достижения желаемого результата, но при этом оно может снизить риск осложнений и улучшить качество жизни женщины в долгосрочной перспективе. В то же время перипартальная гистерэктомия может быть более эффективной в краткосрочной перспективе, но она сопряжена с более высоким риском осложнений.</p></sec><sec><title>Заключение</title><p>Заключение. Врач должен предоставить женщине всю необходимую информацию о рисках и преимуществах каждого метода, а также помочь ей принять обоснованное решение на основе ее индивидуальных потребностей и предпочтений. Органосохраняющее лечение PAS, способствуя сохранению фертильности, обеспечивает более высокое качество жизни с меньшим риском для здоровья матери. В конечном итоге, выбор между перипартальной гистерэктомией и органосохраняющим лечением зависит от конкретной ситуации и состояния здоровья женщины.</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>placenta accreta spectrum</kwd><kwd>PAS</kwd><kwd>гистерэктомия</kwd><kwd>органосохраняющее лечение</kwd><kwd>органосохраняющее ведение</kwd></kwd-group><kwd-group xml:lang="en"><kwd>placenta accreta spectrum</kwd><kwd>PAS</kwd><kwd>hysterectomy</kwd><kwd>organ-preserving treatment</kwd><kwd>organ-preserving management</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Сюндюкова Е.Г., Чуланова Ю.С., Сашенков С.Л. и др. Предлежание и врастание плаценты: вопросы диагностики и акушерской тактики. 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