Strengths and limitations
The study is supported by a large PAS cohort, that is representative of international practice. The study conveyed results of the most used conservative approaches. The study precluded the confounding effect of most clinically relevant determinants of outcomes. However, the study was limited by the inherent disadvantages of retrospective studies. Retrospective approach was selected due to recruitment difficulties associated with uncommon disorders. The study did not include all uterus preserving procedures, such as “leaving the placenta in situ”, which may be less commonly adopted. The study did not include antenatal sonographic features, which were not feasible to assess and include in retrospect while outcomes were already known.