Placenta Accreta
Spectrum (PAS)
Understanding Your Diagnosis
Your Maternal-Fetal Medicine Team · Based on ACOG & SMFM Guidelines
Your placenta has attached
more deeply than usual
Normal
Attachment
PAS
Attachment
In PAS, the placenta grows into — or through — the uterine wall, making separation at delivery more complex.
PAS ranges from mild
to more involved
| Grade | Name | What It Means | Depth |
|---|---|---|---|
| 1 | Accreta | Placenta attaches to the muscle | Surface layer |
| 2 | Increta | Placenta grows into the muscle | Deeper layer |
| 3 | Percreta | Placenta grows through the wall | Full thickness |
How deeply does the placenta invade?
Image: POCUS 101 — used for educational purposes
Normal attachment vs. the three grades of PAS
Each panel shows a different depth of placental attachment into the uterine wall.
Prior uterine surgery is
the most common cause
Scar tissue disrupts the normal boundary between the placenta and uterine wall, allowing deeper attachment.
Risk rises with each
prior cesarean delivery
Ultrasound is the first
and most important test
Early diagnosis allows your team to plan the safest possible delivery for you and your baby.
You will be cared for
by a specialized team
Delivery is planned between
34 – 36 weeks
Scheduling delivery before labor begins significantly reduces the risk of emergency bleeding.
A planned cesarean —
with the placenta left in place
This approach — planned cesarean hysterectomy — is the safest, most effective treatment for most patients with PAS.
Blood transfusion is common —
your team prepares in advance
Hysterectomy ends future pregnancies —
but your options matter
If preserving fertility is important to you, please discuss this openly with your MFM team — there are options to explore together.
Your emotional health
is part of your care
Four steps you can
take right now
- 1️⃣ Ask your team which grade of PAS you have and what it means for your plan.
- 2️⃣ Confirm your delivery center has a dedicated PAS team and experience.
- 3️⃣ Ask about blood donation options and how your team prepares for blood loss.
- 4️⃣ Connect with a counselor or support group — emotional preparation matters.
No question
is too small
Your care team is here to guide you — every step, every question, every concern.
You are not alone
in this
PAS is a complex condition — but it is manageable with the right team, the right center, and the right plan.
Maternal-Fetal Medicine Patient Education · ACOG & SMFM Guidelines · For informational purposes — always discuss your specific situation with your physician.