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Placenta Accreta Spectrum and Complex Obstetric Surgery Program

We provide advanced, specialized obstetric services at Mass General Brigham. Our goal is to provide a healthy, safe delivery for each mother and child through careful preparation, medical expertise, and multidisciplinary teamwork.

Advanced surgical care

Placenta accreta occurs when the placenta attaches too deeply into the uterine wall, often preventing it from delivering after birth and causing heavy bleeding.

Mass General Brigham offers specialized, compassionate care for women who face a complicated delivery due to a cesarean section identified as being complex, risk for heavy bleeding, or need for an additional surgery or hysterectomy.

Patients may come to us at the beginning of their pregnancy, at the time they are diagnosed with a condition, or prior to becoming pregnant.

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Part of Obstetrics and Gynecology
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Our approach to complex obstetric care

No two patients’ situations are alike, and we consider your unique needs and requests. including the potential for fertility sparing surgery when safe. Our goal is to ensure a healthy, safe delivery through careful preparation, medical expertise, and multidisciplinary teamwork.
Planning for labor and delivery in high-risk pregnancy

Our specialists begin by identifying at-risk patients before or early in pregnancy, and carefully plan the timing and steps of the delivery.

By combining this individualized preparation with our rich resource of multidisciplinary specialists, our goal is to make otherwise complicated and difficult deliveries run in a smooth, controlled manner. Afterward, our team offers both immediate and long-term follow-up care.

Patients come to our program with a range of conditions, including placenta previa and accreta spectrum, fibroids and other pelvic tumors, Asherman syndrome, uterine anomalies, endometriosis, severe adhesions or scar tissue, a past history of complicated surgery, and other conditions that make their deliveries more difficult.

Multidisciplinary care for pregnancy complications

Patients are cared for by a multidisciplinary team that includes:

  • High-risk obstetricians and maternal-fetal medicine specialists
  • Obstetric anesthesiologists
  • Neonatal specialists
  • Pelvic and surgical specialists
  • Radiologists
  • ICU teams
  • Blood bank and transfusion specialists
  • Mental health providers
  • Nurses

While all specialists are always available, our high-risk obstetricians lead most procedures, including cesarean delivery, hysterectomy, and hemorrhage management.

While many patients come to our service for complicated cesarean deliveries, we will support a vaginal delivery when this is an option. With our high delivery volume, we have extensive experience managing complex births, including VBAC and postpartum complications.

Specialized surgical services
Our patients have access to advanced obstetric services, including hybrid operating rooms where specialists work together during complex procedures, and 24/7 cell salvage for patients at risk of heavy bleeding.
Family-centered cesarean delivery
When cesarean delivery is needed, we aim to make the experience as personal and supportive as possible while maintaining safety. Most patients may be eligible for a family-centered approach that allows you to see your baby at birth and encourages early contact, even during complex deliveries. Our program is focused on the patient experience before, during, and after the delivery.
Coordinated care before and after pregnancy
We coordinate care with infertility and minimally invasive surgical specialists for patients who need uterine surgery or fertility treatment. Our team works closely with gynecologists experienced in fibroids, retained placenta, and uterine scar complications, and provides ongoing gynecologic and mental health support when needed.
Research for the future

Researchers at Mass General Brigham are working to understand the connection between scars from prior uterine surgeries, such as C-sections, and placental complications.

You may have the option to participate in research that helps us understand more about how surgery impacts subsequent pregnancies. This allows us to make future pregnancies safer.