Conservative management of placenta accreta spectrum (PAS) includes delivery of the fetus with retention of the placenta in situ. There are insufficient data evaluating the effect of leaving the placenta in situ with PAS on the ability to establish lactation. We performed a prospective cohort study of 126 patients diagnosed with PAS. Clinical data pertaining to breastfeeding were obtained, as well as laboratory values for β-hCG and progesterone. Our objective was to assess breast-milk production measured by time of onset of stage II lactogenesis and hormone values in individuals managed with placental retention compared with those undergoing hysterectomy. We found that the average time for onset of stage II lactogenesis was 5.6 days with conservative management and 3.8 days with cesarean hysterectomy ( P =.07). Although β-hCG levels did not differ between groups, postpartum progesterone levels were lower in the cesarean hysterectomy group compared with the retained placenta group (1.86 ng/mL vs 62.9 ng/mL, P <.001).

中文翻译：

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侵入性胎盘谱系和母乳分泌的保守治疗。


侵入性胎盘谱系 （PAS） 的保守治疗包括胎儿分娩并原位保留胎盘。没有足够的数据评估用 PAS 将胎盘留在原位对建立泌乳能力的影响。我们对 126 例诊断为 PAS 的患者进行了一项前瞻性队列研究。获得了与母乳喂养相关的临床数据，以及 β-hCG 和孕酮的实验室值。我们的目的是评估与接受子宫切除术的个体相比，胎盘滞留个体的 II 期泌乳开始时间和激素值测量的母乳分泌量。我们发现 II 期泌乳发生的平均时间为保守治疗 5.6 天，剖宫产子宫切除术为 3.8 天 （P =.07）。虽然两组间 β-hCG 水平没有差异，但与胎盘保留组相比，剖宫产子宫切除术组的产后孕激素水平较低 （1.86 ng/mL vs 62.9 ng/mL，P <.001）。