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Massachusetts General Hospital

Translational PAS research and multidisciplinary surgical care within the Mass General Brigham system

Last reviewed: March 2026

Key Takeaways

  • MGH is part of the Mass General Brigham health system (sister hospital to Brigham and Women's), with access to extensive surgical and critical care resources
  • The program is led by Dr. Christina Duzyj Buniak, who directs the MFM Fellowship and serves as Labor & Delivery Medical Director
  • MGH has a Level III NICU (21 beds) with ECMO capability — a rare resource for the most critical neonatal cases
  • The hospital is a leader in basic science and translational PAS research, including collagen architecture and trophoblast invasion studies
  • Fertility preservation through conservative (uterine-sparing) management has not been confirmed in publicly available materials — patients who prioritize uterine preservation should discuss this directly with the care team

Program Overview

Massachusetts General Hospital (MGH) is the original and largest teaching hospital of Harvard Medical School and a founding member of the Mass General Brigham (MGB) health system. As a sister institution to Brigham and Women's Hospital, MGH has access to system-wide expertise in complex obstetric and gynecologic surgery.

The hospital manages PAS cases through its Division of Maternal-Fetal Medicine, coordinating a multidisciplinary team that includes vascular surgery — a specialty not always represented on PAS teams at other centers. MGH's approach to PAS integrates clinical care with a strong translational research program focused on understanding the molecular mechanisms of abnormal placental invasion.

MGH contributed to the 2024 NICHD Workshop on PAS care infrastructure, reflecting its role in shaping national standards for PAS management.2

Fertility Preservation Status

🚨 Fertility Preservation: Not Confirmed

Based on publicly available materials, MGH has not documented a conservative (uterine-sparing) management protocol for PAS. The hospital's published research focuses on basic science — collagen architecture, extracellular matrix remodeling, and trophoblast invasion mechanisms — rather than clinical fertility preservation outcomes.

This does not necessarily mean uterine preservation is never attempted at MGH, but there are no published case series, named protocols, or patient-facing materials describing such an approach. If preserving your uterus is a priority, ask your MGH care team directly about their experience with conservative management and what options may be available in your specific case.

Key Physicians

Dr. Christina Duzyj Buniak, MD

  • Role: Director of MFM Fellowship; Medical Director of Labor & Delivery
  • Specialty: Maternal-Fetal Medicine
  • Affiliation: Massachusetts General Hospital, Harvard Medical School
  • Research focus: Placental biology, collagen architecture in PAS, extracellular matrix remodeling, trophoblast invasion
  • Notable: Participant in the NICHD Workshop on PAS care infrastructure; lead author on disrupted collagen architecture study

Multidisciplinary Team Composition

PAS cases at MGH are managed by a multidisciplinary team that includes:

  • Maternal-Fetal Medicine (MFM) — overall care coordination, prenatal monitoring, and delivery planning
  • Gynecologic surgery — surgical management during cesarean delivery
  • Vascular surgery — management of major vessel involvement and hemorrhage control (a distinctive feature of the MGH team)
  • Interventional radiology — balloon catheter placement, uterine artery embolization
  • Anesthesiology — specialized obstetric anesthesia, massive transfusion management
  • Neonatology — Level III NICU with 21 beds and ECMO capability
  • Blood bank / transfusion medicine — massive transfusion protocol support
  • Critical care — ICU-level postoperative monitoring
📌 ECMO-Capable NICU

MGH's Level III NICU is one of the few in the region with ECMO (extracorporeal membrane oxygenation) capability. ECMO provides temporary heart and lung support for critically ill newborns. While most PAS babies will not need ECMO, its availability provides an additional safety net for the most complex cases, particularly those involving extreme prematurity or respiratory failure.

Published Outcomes

MGH's PAS research has focused primarily on understanding the biological mechanisms underlying abnormal placentation rather than reporting surgical outcome series. Key contributions include:

Disrupted Collagen Architecture

A study led by MGH researchers examined the extracellular matrix (ECM) in PAS tissue compared to normal placentation. The findings revealed significant disruption of collagen fiber architecture in accreta specimens, providing new insight into why the placenta invades abnormally deep into the uterine wall. This basic science work may eventually inform new diagnostic or therapeutic approaches.1

PAS Care Infrastructure

MGH investigators contributed to a review of PAS care delivery systems, examining how specialized centers organize their multidisciplinary teams, referral networks, and quality improvement programs. This work helps define what "center of excellence" means in practical terms.2

NICHD Workshop Participation

MGH faculty participated in the NICHD (National Institute of Child Health and Human Development) Workshop that brought together PAS experts to identify research priorities and care standards. The workshop summary outlines key gaps in PAS knowledge and recommended directions for future investigation.3

Clinical Trials

MGH's research strength lies in translational and basic science investigation. As of March 2026, the hospital's PAS-related research is focused on:

  • Molecular mechanisms of trophoblast invasion and placental attachment
  • Collagen and extracellular matrix remodeling in the myometrium
  • Biomarker development for early PAS detection

Patients interested in participating in PAS-related research studies should ask their MFM provider about currently enrolling protocols. Clinical trial information can also be searched at ClinicalTrials.gov using the terms "placenta accreta" and "Massachusetts General Hospital."

Practical Information

Contact

  • Hospital: Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114
  • Department: Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology
  • Phone: 617-726-2000 (main); request Maternal-Fetal Medicine for PAS referrals
  • Website: massgeneral.org

Insurance

MGH accepts most major insurance plans. As part of the Mass General Brigham system, coverage may vary depending on your specific plan and network. Contact the hospital's financial services or your insurance provider to verify coverage before scheduling, especially for out-of-state patients.

Telemedicine

Mass General Brigham offers virtual visits through its patient portal. Initial PAS consultations may be available via telemedicine for patients traveling from a distance, though in-person evaluation will be needed for imaging and surgical planning. Ask about telemedicine options when scheduling your appointment.

References

  1. Duzyj Buniak CM, et al. Disrupted collagen architecture in placenta accreta spectrum. 2025. PMID: 41485849
  2. PAS care infrastructure and delivery systems: a review. 2023. PMID: 37984691
  3. NICHD Workshop Summary: Placenta Accreta Spectrum — Research Priorities and Care Standards. 2025. PMID: 40311146
  4. ACOG/SMFM Obstetric Care Consensus No. 7: Placenta Accreta Spectrum. Obstet Gynecol. 2018;132(6):e259-e275. PMID: 30461695