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Johns Hopkins Hospital

Advanced Obstetric Surgery Center with dual-certified critical care expertise and pioneering CT angiography for PAS

Last reviewed: March 2026

Key Takeaways

  • Johns Hopkins treats approximately 36 PAS cases per year (~3 per month) through its Advanced Obstetric Surgery Center
  • Both Dr. Vaught and Dr. Halscott are dual board-certified in MFM and Critical Care — an uncommon depth of expertise
  • Their team-managed protocol achieved a 48% reduction in blood loss, 40% reduction in transfusion, and 50% reduction in ICU admission
  • Pioneered the use of CT angiography for PAS surgical planning — first published in the literature
  • Fertility preservation is not confirmed as part of their standard approach — see details below

Program Overview

The Johns Hopkins Hospital Advanced Obstetric Surgery Center in Baltimore is a Level IV Maternal Care Center that manages complex surgical obstetric cases, with PAS as a core focus. The center treats approximately 36 PAS patients per year (roughly 3 per month), making it one of the higher-volume programs on the East Coast.

What distinguishes the Hopkins program is its critical care depth. Both of the program's lead physicians hold dual board certification in Maternal-Fetal Medicine and Critical Care Medicine, ensuring that the sickest patients have intensivist-level expertise immediately available in the operating room and the ICU.

The program also holds a monthly PAS-specific multidisciplinary conference, where upcoming and recently managed cases are reviewed by the full team to continuously refine protocols and outcomes.

Fertility Preservation Status

🚨 Fertility Preservation: Not Confirmed

If preserving your uterus and future fertility is your top priority, please read this carefully. Johns Hopkins' published outcomes and program focus center on optimized cesarean hysterectomy — performing the surgery as safely as possible with minimal blood loss and complications. We were unable to identify published data from Johns Hopkins on conservative (uterus-preserving) PAS management or a documented fertility-preservation program.

This does not mean that Hopkins is not an excellent choice for many PAS patients. Their outcomes for cesarean hysterectomy are among the best published. However, if your goal is to avoid hysterectomy, you should specifically ask the care team whether conservative management is available for your case and consider seeking a consultation at a center with published conservative management experience.

Key Physicians

Arthur “Jason” Vaught, MD

Director, Labor & Delivery; Advanced Obstetric Surgery Center

Dr. Vaught is dual board-certified in Obstetrics & Gynecology and Critical Care Medicine. He leads the PAS surgical program and has been instrumental in establishing the team-managed protocols that dramatically improved outcomes. His critical care training provides a unique perspective on intraoperative and postoperative management of PAS patients.1

Torre Halscott, MD, MS

Maternal-Fetal Medicine & Critical Care

Dr. Halscott is also dual-certified in MFM and Critical Care, making the Hopkins program unusual in having two such specialists. This redundancy ensures that critical care expertise is always available for PAS cases, regardless of scheduling or emergencies.

Erin Gomez, MD

Interventional Radiology

Dr. Gomez leads the radiology component of the PAS team, including the program's pioneering work with CT angiography for PAS surgical planning. This imaging approach helps the surgical team map the blood supply to the placenta and plan for hemorrhage control before entering the operating room.2

Multidisciplinary Team Composition

The Johns Hopkins PAS team includes:

  • Maternal-Fetal Medicine / Critical Care — dual-certified specialists (Drs. Vaught, Halscott)
  • Gynecologic Oncology — for complex pelvic dissection
  • Interventional Radiology — CT angiography, balloon occlusion, embolization (Dr. Gomez)
  • Urology — for bladder and ureteral involvement
  • Obstetric Anesthesiology — dedicated high-risk OB anesthesia
  • Neonatology — Level IV NICU
  • Blood Bank / Transfusion Medicine — massive transfusion protocol, cell salvage
  • Nursing — specialized L&D and OR nursing team

The team holds a monthly PAS multidisciplinary conference to review upcoming cases, debrief completed cases, and continuously improve protocols. This regular case review is a hallmark of mature PAS programs.

Published Outcomes

Johns Hopkins has published strong outcome data demonstrating the impact of their team-managed approach to PAS surgery:1

Outcome Measure Improvement with Team-Managed Protocol
Blood Loss 48% reduction
Blood Transfusion 40% reduction
ICU Admission 50% reduction

These improvements reflect the transition from case-by-case management to a standardized, protocol-driven MDT approach — a pattern seen at every major PAS center that has published before-and-after data.

CT Angiography Innovation

Johns Hopkins was the first to publish on the use of CT angiography specifically for PAS surgical planning. This imaging modality provides detailed three-dimensional mapping of the abnormal blood vessels feeding the accreta placenta, allowing surgeons to anticipate and prepare for the specific hemorrhage risks of each individual case. While not yet standard at all PAS centers, this approach represents a meaningful advance in personalized surgical planning.2

Clinical Trials

Johns Hopkins has an active research program in PAS-related topics, including surgical technique optimization, imaging innovation, and maternal critical care outcomes. Patients interested in current study enrollment should inquire directly with the care team during their consultation.

The program's monthly PAS conference also serves as a forum for evaluating new techniques and technologies for potential incorporation into clinical practice.

Practical Information

Contact

Telemedicine

Johns Hopkins offers telemedicine consultations for PAS patients, making initial evaluation accessible for patients who cannot easily travel to Baltimore. Virtual visits can be arranged through the main phone line or the fetal therapy referral line.

Insurance

Johns Hopkins Medicine accepts most major insurance plans. Given the complexity of PAS care, early contact with the hospital's financial counseling team is recommended to verify coverage and obtain necessary pre-authorizations, especially for out-of-state patients.

Travel Considerations

Baltimore is served by Baltimore/Washington International Airport (BWI), with the Johns Hopkins Hospital campus located approximately 20 minutes from the airport. The hospital is also accessible from Washington, D.C. (approximately 1 hour by car or train). Patient housing and hotel options are available near the hospital campus.

Designations

  • Level IV Maternal Care Center
  • Level IV NICU

References

  1. Vaught AJ, et al. Effect of a multidisciplinary team approach on outcomes in patients with placenta accreta spectrum. Obstet Gynecol. PMID: 33957646
  2. Defined Vascular Territories of Placenta Accreta Spectrum by CT Angiography. Johns Hopkins Medicine. Published in Radiology.
  3. ACOG/SMFM Obstetric Care Consensus No. 7: Placenta Accreta Spectrum. Obstet Gynecol. 2018;132(6):e259-e275. PMID: 30461695
  4. Jauniaux E, et al. FIGO Consensus Guidelines on Placenta Accreta Spectrum Disorders. Int J Gynecol Obstet. 2018. PMID: 29405319