Classification and reporting guidelines for the pathology diagnosis of placenta accreta spectrum (PAS) disorders: recommendations from an expert panel

Jonathan L Hecht, Rebecca Baergen, Linda M Ernst, Philip J Katzman, Suzanne M Jacques, Eric Jauniaux, T Yee Khong, Leon A Metlay, Liina Poder, Faisal Qureshi, Joseph T Rabban 3rd, Drucilla J Roberts, Scott Shainker, Debra S Heller, Jonathan L Hecht, Rebecca Baergen, Linda M Ernst, Philip J Katzman, Suzanne M Jacques, Eric Jauniaux, T Yee Khong, Leon A Metlay, Liina Poder, Faisal Qureshi, Joseph T Rabban 3rd, Drucilla J Roberts, Scott Shainker, Debra S Heller

Abstract

The terminology and diagnostic criteria presently used by pathologists to report invasive placentation is inconsistent and does not reflect current knowledge of the pathogenesis of the disease or the needs of the clinical care team. A consensus panel was convened to recommend terminology and reporting elements unified across the spectrum of PAS specimens (i.e., delivered placenta, total or partial hysterectomy with or without extrauterine tissues, curetting for retained products of conception). The proposed nomenclature under the umbrella diagnosis of placenta accreta spectrum (PAS) replaces the traditional categorical terminology (placenta accreta, increta, percreta) with a descriptive grading system that parallels the guidelines endorsed by the International Federation of Gynaecology and Obstetrics (FIGO). In addition, the nomenclature for hysterectomy specimens is separated from that for delivered placentas. The goal for each element in the system of nomenclature was to provide diagnostic criteria and guidelines for expected use in clinical practice.

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