This study evaluates whether adding Hayman sutures in the conservative Management of Placenta Accreta Spectrum Using Kasr Al-Ainy Technique reduces intraoperative blood loss and improves outcomes

Inclusion Criteria:

• Age 18-40 years
• Antenatal PAS diagnosis confirmed by TAS/TVS/Doppler
• Eligible for conservative Kasr Al-Ainy surgery
• Singleton pregnancy
• Written informed consent

Exclusion Criteria:

• Multiple pregnancy
• Uterine fibroids
• Previous cesarean myomectomy
• Cervical accreta
• Extensive parametrial or bladder invasion requiring hysterectomy
• Known coagulopathy or uncorrected bleeding disorder.
• Severe medical comorbidities rendering the patient unfit for major surgery under general anesthesia (e.g., severe cardiac or pulmonary disease)
• Medical disorders as HTN and DM
• Patient refusal