Penn Medicine — PAS Center of Excellence

Program Overview

The Penn Medicine PAS Center of Excellence in Philadelphia, PA is a newly established program dedicated to the multidisciplinary management of placenta accreta spectrum. Led by Dr. Beth L. Pineles, the center is part of the University of Pennsylvania Health System — one of the nation's top academic medical centers.

Dr. Pineles founded the program to bring conservative management expertise to the East Coast, drawing on her training at UTHealth Houston where she gained hands-on experience with the leaving-placenta-in-situ approach. The center leverages Penn's extensive resources in maternal-fetal medicine, surgical subspecialties, and clinical research infrastructure to offer patients a full range of PAS treatment options, including fertility-preserving strategies.

Fertility Preservation Status

Post-Delivery Imaging Timeline

Penn investigators have published imaging research describing the expected post-delivery timeline for placental resorption after conservative management. This work helps establish imaging benchmarks that clinicians can use to monitor patients during the weeks-to-months follow-up period, distinguishing normal resorption from complications that may require intervention.4

Conservative management at Penn involves leaving the placenta in situ after cesarean delivery, with structured follow-up including serial imaging and laboratory monitoring. By prospectively studying this approach, the U-PRESERVE trial aims to generate the rigorous evidence needed to establish conservative management as a standard option at US centers. Patients interested in this approach should inquire about trial eligibility during consultation.

Key Physicians

Clinical Trials

The cornerstone of Penn Medicine's PAS research program is the U-PRESERVE trial, a landmark prospective study of uterine preservation for placenta accreta spectrum.

U-PRESERVE Trial Details

• ClinicalTrials.gov ID: NCT05139498
• Design: Single-arm, single-site pilot study
• Enrollment: 15 patients
• Intervention: Conservative management (leaving placenta in situ) for patients with PAS desiring uterine preservation
• Status: Currently recruiting
• Principal Investigator: Dr. Beth L. Pineles

This trial represents the first US prospective study specifically evaluating uterine preservation for PAS. The results will help establish the evidence base for conservative management as a viable option at American medical centers. Patients interested in participating should contact the Penn Medicine PAS Center of Excellence to discuss eligibility.2

Published Research

Conservative Management Feasibility (AJOG MFM 2023)

In a perspective published in AJOG MFM, Pineles et al. argued that conservative management of placenta accreta spectrum is practical in the United States. The paper made the case that the leaving-placenta-in-situ approach — widely used internationally — is feasible within the US healthcare system and should be offered to appropriately selected patients who desire uterine preservation. This publication helped lay the intellectual groundwork for the U-PRESERVE trial.1

UTHealth Houston Case Series (Am J Perinatol 2024)

Prior to establishing the Penn program, Dr. Pineles published an 11-patient case series from UTHealth Houston reporting outcomes of conservative management for PAS. The series demonstrated a 55% uterine preservation rate, providing early US-based evidence supporting the feasibility and safety of this approach.3

Practical Information

Location

• Institution: Penn Medicine / University of Pennsylvania Health System
• City: Philadelphia, PA

Website

• pennmedicine.org — PAS Center of Excellence page

Travel Considerations

Philadelphia is served by Philadelphia International Airport (PHL) with direct flights from most major US cities. Penn Medicine's Hospital of the University of Pennsylvania is located in the University City neighborhood of West Philadelphia, approximately 20 minutes from the airport.

References