Surgical Management of Placenta Accreta Spectrum Disorders Using Total Lower Segmentectomy With Cervico-Corporeal Anastomosis and Adjunctive Mechanical Towel Compression

The goal of this observational study is to evaluate the feasibility and safety of utilizing adjunctive mechanical towel compression during TLS-CCA, measured primarily by estimated intraoperative blood loss in patient with Maternal age 18-45 years - Singleton pregnancy - Antenatal diagnosis of PAS (ultrasound ± MRI) - Planned elective cesarean delivery - Candidate for uterine preservation via TLS-CCA - Provided written informed consent

Inclusion Criteria: * Maternal age 18-45 years * Singleton pregnancy * Antenatal diagnosis of PAS (ultrasound ± MRI) * Planned elective cesarean delivery * Candidate for uterine preservation via TLS-CCA * Provided written informed consent Exclusion Criteria: * Hemodynamic instability necessitating emergency hysterectomy * Placental invasion into adjacent pelvic organs requiring exenteration * Pre-existing severe coagulation disorders * Multiple gestation or major fetal anomalies * Patient refusal to participate