Placenta accreta syndrome without placenta previa represents a rare and complex obstetric condition characterized by abnormal placental adherence without the anterior placental location overlying the cervix, as is characteristically seen in cases with previa. This unique presentation complicates prenatal diagnosis, often leading to delays in management and increased risks of maternal morbidity and mortality. This review comprehensively evaluates diagnostic challenges, surgical and conservative management strategies, associated complications, and outcomes specific to placenta accreta syndrome without placenta previa. MEDLINE/PubMed, ScienceDirect, Google Scholar, and EMBASE were used for the search and only relevant and up-to-date studies were included in the analysis. The study selection for this literature review was followed by The Preferred Reporting Items for Systematic Reviews and Meta-analyses checklist. The integration of ultrasound and magnetic resonance imaging modalities, coupled with standardized diagnostic criteria, enhances early detection and facilitates preoperative planning. This analysis showed that, in addition to conservative management, vascular management, including uterine artery embolization and balloon occlusion, is particularly beneficial in high-risk cases and requires collaboration with interventional radiologists to ensure successful implementation. In addition, all the studies highlight the importance of coordinated input from obstetricians, surgeons, anesthesiologists, interventional radiologists, and critical care teams, with specialized centers having the resources and expertise needed for optimal care. The findings highlight critical gaps in current knowledge and stress the need for standardized protocols and further research to optimize maternal and fetal outcomes.
Bapayeva et al. (2025) studied this question.