# Conservative management as an alternative to hysterectomy for placenta accreta spectrum.

> **NIH NIH K23** · UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH · 2024 · $171,720

## Abstract

PROJECT SUMMARY/ABSTRACT
 This is an application for a K23 award for Dr. Brett Einerson, a Maternal-Fetal Medicine (MFM) physician at
the University of Utah. Dr. Einerson is a promising young investigator in placenta accreta spectrum (PAS)
research. His long-term career goal is to become an independent investigator and national leader of PAS
studies that evaluate treatments for PAS, including in situ conservative management (CM). This K23 award will
provide Dr. Einerson with the protected time and mentored support to accomplish the following career goals: 1]
develop expertise in clinical trial design and management; 2] acquire proficiency in interview study design and
qualitative assessment; 3] obtain advanced skills in health economic evaluation; and 4] develop and strengthen
research leadership and management skills. To achieve these goals, Dr. Einerson assembled a mentoring
team comprising a primary mentor, Dr. Robert Silver, a MFM physician and international leader in PAS
research, and two co-mentors: Dr. Erin Rothwell, a NIH-funded scientist and expert in shared decision-making,
qualitative research, and research ethics, and Dr. Richard Nelson, a federally-funded health economist. Dr.
Einerson also has four advisors with expertise in clinical trials, CM, and multicenter research leadership.
 PAS is an extremely morbid and increasingly common pregnancy condition that often results in massive
obstetric hemorrhage. The standard treatment in the US is hysterectomy, but this treatment is complex,
morbid, and costly. A promising alternative for PAS treatment is CM, a strategy in which the placenta is left in
the uterus. Unfortunately, there are insufficient data available to compare outcomes of these two treatments
because past studies are limited by non-randomized study designs, minimal inclusion of patient values in
making treatment decisions, and nominal consideration of economic barriers to care. A large clinical trial
comparing PAS treatments is needed. Dr. Einerson's research will provide essential data to prepare for a
randomized clinical trial and will provide the evidence base for enhanced shared decision-making regarding
treatments for PAS. He will (Aim 1) evaluate the feasibility of randomizing patients to CM for PAS; (Aim 2)
identify the information needs, outcome priorities, and shared decision-making preferences for PAS; and (Aim
3) quantify the cost of PAS treatments. In Aim 1, Dr. Einerson will design and implement a pilot trial of PAS
patients randomized to CM or hysterectomy to evaluate feasibility of a larger trial. In Aim 2, Dr. Einerson will
conduct interviews with patients, clinicians, and partners to assess the information needs and values of those
who are part of making treatment decisions for PAS. In Aim 3, Dr. Einerson will compare the cost of PAS
treatments using advanced economic analytics.
 The expected outcome will lay the groundwork for a large clinical trial of CM versus hysterectomy for PAS
and help to establish th...

## Key facts

- **NIH application ID:** 10892662
- **Project number:** 5K23HD106009-04
- **Recipient organization:** UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH
- **Principal Investigator:** Brett David Einerson
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $171,720
- **Award type:** 5
- **Project period:** 2021-08-12 → 2026-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10892662

## Citation

> US National Institutes of Health, RePORTER application 10892662, Conservative management as an alternative to hysterectomy for placenta accreta spectrum. (5K23HD106009-04). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10892662. Licensed CC0.

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