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.