{"id":61987,"date":"2025-12-19T10:21:46","date_gmt":"2025-12-19T03:21:46","guid":{"rendered":"https:\/\/www2.si.mahidol.ac.th\/en\/?p=61987"},"modified":"2026-02-20T09:15:14","modified_gmt":"2026-02-20T02:15:14","slug":"placental-accreta-spectrum-pas","status":"publish","type":"post","link":"https:\/\/www2.si.mahidol.ac.th\/en\/highlights\/placental-accreta-spectrum-pas\/","title":{"rendered":"Placental Accreta Spectrum (PAS)"},"content":{"rendered":"<div id='av_section_1'  class='avia-section av-dra2avn-846143f308b75fcfeacc6fe56bdd46f3 main_color avia-section-small avia-no-border-styling  avia-builder-el-0  el_before_av_section  avia-builder-el-first  avia-bg-style-scroll container_wrap fullsize'  ><div class='container av-section-cont-open' ><main  role=\"main\" itemprop=\"mainContentOfPage\"  class='template-page content  av-content-full alpha units'><div class='post-entry post-entry-type-page post-entry-61987'><div class='entry-content-wrapper clearfix'>\n<div  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https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2025\/12\/uterus-asian-woman-holding-human-anatomy-model-2025-04-27-07-10-12-utc-705x470.jpg 705w\" sizes=\"(max-width: 1920px) 100vw, 1920px\" \/><\/div><\/div><\/div><\/div><div  class='flex_column av-bq3lc6r-6742f0a8275e6316d1e11866a108d315 av_one_fifth  avia-builder-el-6  el_after_av_three_fifth  avia-builder-el-last  flex_column_div  '     ><\/div><\/div><\/div><\/div><!-- close content main div --><\/div><\/div><div id='av_section_3'  class='avia-section av-bfyt1ub-3c6bd9f07dfa953f3f7f69ee7ccca494 main_color avia-section-default avia-no-border-styling  avia-builder-el-7  el_after_av_section  el_before_av_section  avia-bg-style-scroll container_wrap fullsize'  ><div class='container av-section-cont-open' ><div class='template-page content  av-content-full alpha units'><div class='post-entry post-entry-type-page post-entry-61987'><div class='entry-content-wrapper clearfix'>\n<div  class='flex_column av-azxw0nn-454298c0621018552d10e99435887e63 av_one_fifth  avia-builder-el-8  el_before_av_three_fifth  avia-builder-el-first  first flex_column_div  '     ><\/div><div  class='flex_column av-agrumj7-bbf9721ce0ff99fba0bf95fff84d5387 av_three_fifth  avia-builder-el-9  el_after_av_one_fifth  el_before_av_one_fifth  flex_column_div  '     ><section  class='av_textblock_section av-9x2kxkj-d8c71be483043ffa1e7757eeb4935264 '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/BlogPosting\" itemprop=\"blogPost\" ><div class='avia_textblock'  itemprop=\"text\" ><header aria-label=\"Article header\">\n<header aria-label=\"Article header\">\n<h1><b>Placental Accreta Spectrum (PAS)<\/b><\/h1>\n<\/header>\n<div class=\"relative reader__grid\">\n<div class=\"reader-author-info__container\">\n<div class=\"display-flex align-items-center justify-space-between\">\n<div class=\"reader-author-info__inner-container\">\n<div id=\"ember371\" class=\"artdeco-entity-lockup artdeco-entity-lockup--size-3 ember-view\">\n<div id=\"ember372\" class=\"artdeco-entity-lockup__image artdeco-entity-lockup__image--type-square ember-view\"><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/header>\n<div class=\"relative reader__grid\">\n<div class=\"reader-author-info__container\">\n<div class=\"display-flex align-items-center justify-space-between\">\n<div class=\"reader-author-info__inner-container\">\n<div id=\"ember2242\" class=\"artdeco-entity-lockup artdeco-entity-lockup--size-3 ember-view\">\n<div id=\"ember2243\" class=\"artdeco-entity-lockup__image artdeco-entity-lockup__image--type-square ember-view\"><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div><\/section><\/div><div  class='flex_column av-98ujbtf-5f92ecb5d7864414b03e7c0cdba41685 av_one_fifth  avia-builder-el-11  el_after_av_three_fifth  el_before_av_one_fifth  flex_column_div  '     ><\/div><div  class='flex_column av-w6kovn-d26a3514e9abb75494244346ce99e915 av_one_fifth  avia-builder-el-12  el_after_av_one_fifth  el_before_av_three_fifth  first flex_column_div  column-top-margin'     ><\/div><div  class='flex_column av-8iqog9f-878b04e3cdd53b03586d0e66c860c93a av_three_fifth  avia-builder-el-13  el_after_av_one_fifth  el_before_av_one_fifth  flex_column_div  column-top-margin'     ><p><section  class='av_textblock_section av-87ki54j-f657560a61834e643e2384f80c7f30c7 '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/BlogPosting\" itemprop=\"blogPost\" ><div class='avia_textblock'  itemprop=\"text\" ><p><strong>Assoc. Prof. Pavit Sutchritpongsa\u00a0<\/strong><\/p>\n<p><span style=\"font-weight: 400;\">Department of Obstetrics &amp; Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University<\/span><\/p>\n<\/div><\/section><br \/>\n<section  class='av_textblock_section av-mjcatnvx-73645a6ef9c582deef17461884b4a110 '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/BlogPosting\" itemprop=\"blogPost\" ><div class='avia_textblock'  itemprop=\"text\" ><p><b>Placental Accreta Spectrum (PAS)<\/b><span style=\"font-weight: 400;\"> is a condition in which the placenta abnormally attaches and grows too firmly into the wall of the uterus. In some cases, it grows so deeply that it is difficult to separate from the uterus after delivery, which can cause severe bleeding. This condition carries a high level of risk and can be dangerous for both the mother and the baby.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">This condition occurs because the <\/span><b>decidua basalis<\/b><span style=\"font-weight: 400;\"> (the normal tissue layer that separates the placenta from the uterine muscle) is absent. As a result, parts of the placenta called <\/span><b>placental villi<\/b><span style=\"font-weight: 400;\"> (finger-like structures that help the placenta attach and exchange nutrients) can implant directly into the wall of the uterus and grow into the uterine muscle layer. This causes the placenta to attach much more firmly to the uterus than normal. The severity of PAS therefore depends on how deeply the placental villi invade the uterine muscle.<\/span><\/p>\n<\/div><\/section><br \/>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-7kf1fdf-3ed387294c605bcb0d2000f7fe5235ac\">\n#top .av_textblock_section.av-7kf1fdf-3ed387294c605bcb0d2000f7fe5235ac .avia_textblock{\ncolumn-count:2;\n}\n<\/style>\n<section  class='av_textblock_section av-7kf1fdf-3ed387294c605bcb0d2000f7fe5235ac '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/BlogPosting\" itemprop=\"blogPost\" ><div class='avia_textblock av_multi_colums'  itemprop=\"text\" ><p><span style=\"font-weight: 400;\">The <\/span><b>International Federation of Gynecology and Obstetrics (FIGO)<\/b><span style=\"font-weight: 400;\"> classifies the severity of Placental Accreta Spectrum (PAS) into <\/span><b>three levels<\/b><span style=\"font-weight: 400;\">, as follows:<\/span><\/p>\n<p><b>Placenta accreta (Grade 1)<\/b><b><br \/>\n<\/b><span style=\"font-weight: 400;\">The placental villi (finger-like structures of the placenta) grow through the decidua basalis but do not reach the uterine muscle layer (<\/span><b>myometrium<\/b><span style=\"font-weight: 400;\">).<\/span><\/p>\n<p><b>Placenta increta (Grade 2)<\/b><b><br \/>\n<\/b><span style=\"font-weight: 400;\">The placental villi grow into the uterine muscle layer (<\/span><b>myometrium<\/b><span style=\"font-weight: 400;\">).<\/span><\/p>\n<p><b>Placenta percreta (Grade 3)<\/b><b><br \/>\n<\/b><span style=\"font-weight: 400;\">The placental villi grow completely through the uterine muscle and reach the outer covering of the uterus (<\/span><b>uterine serosa<\/b><span style=\"font-weight: 400;\">) or nearby organs, such as the bladder.<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Grade 3A:<\/b><span style=\"font-weight: 400;\"> The placental villi reach the outer layer of the uterus (<\/span><b>uterine serosa<\/b><span style=\"font-weight: 400;\">).<\/span>&nbsp;<\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Grade 3B:<\/b><span style=\"font-weight: 400;\"> The placental villi extend into the bladder.<\/span>&nbsp;<\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Grade 3C:<\/b><span style=\"font-weight: 400;\"> The placental villi extend into other organs, such as the intestines.<\/span><\/li>\n<\/ul>\n<p><b>Conclusion: The Future of Healthcare<\/b><\/p>\n<p><b>Risk Factors<\/b><\/p>\n<ul>\n<li><span style=\"font-weight: 400;\"> Having a previous cesarean section; the risk increases with multiple cesarean deliveries.<\/span><\/li>\n<li><span style=\"font-weight: 400;\"> Having a history of uterine surgery, such as surgery to remove uterine fibroids (<\/span><b>myomectomy<\/b><span style=\"font-weight: 400;\">).<\/span><\/li>\n<li><span style=\"font-weight: 400;\"> Undergoing multiple uterine curettage procedures.<\/span><\/li>\n<li><span style=\"font-weight: 400;\"> Having a low-lying placenta (<\/span><b>placenta previa<\/b><span style=\"font-weight: 400;\">).<\/span><\/li>\n<li><span style=\"font-weight: 400;\"> Having advanced maternal age.<\/span><\/li>\n<\/ul>\n<p><b>Symptoms and Diagnosis<\/b><\/p>\n<p><span style=\"font-weight: 400;\">Most women do not have clear symptoms before delivery. However, doctors may suspect PAS based on a review of risk factors and examination using ultrasound (high-frequency sound waves). Typical findings may include the absence of the <\/span><b>hypoechoic zone<\/b><span style=\"font-weight: 400;\"> (a clear layer normally seen between the placenta and the uterus), the presence of <\/span><b>lacunae<\/b><span style=\"font-weight: 400;\"> (irregular blood-filled spaces) within the placenta, and the placental tissue extending beyond the normal uterine border.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">In some cases, <\/span><b>magnetic resonance imaging (MRI)<\/b><span style=\"font-weight: 400;\"> may be used to help assess the severity of the condition and how far the placenta has spread before planning treatment.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">A key principle of care is preparation by a multidisciplinary team, which includes obstetricians, anesthesiologists, urologic surgeons, hematologists, and the blood bank.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The appropriate timing for delivery is usually a planned cesarean section. In general, delivery is recommended during the late preterm period, around 34 + 0 to 36 + 6 weeks of pregnancy. In more severe cases, delivery is often planned at 34 &#8211; 35 weeks of gestation.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The standard treatment is a cesarean section followed by removal of the uterus together with the placenta, known as <\/span><b>cesarean hysterectomy with the placenta left in place (placenta in situ)<\/b><span style=\"font-weight: 400;\">. This approach is used to prevent heavy bleeding.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">In selected cases, <\/span><b>conservative management<\/b><span style=\"font-weight: 400;\">, which aims to preserve the uterus, may be considered for women who wish to have more children. This option is usually limited to cases with lower severity and requires very close medical monitoring.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">In the past, treatment of PAS was considered extremely complex and required extensive preparation. Interventional radiology procedures were often performed to block the uterine blood vessels, such as <\/span><b>uterine artery embolization<\/b><span style=\"font-weight: 400;\">, before cesarean delivery. Patients usually needed postoperative care in the intensive care unit (ICU), large amounts of blood had to be reserved and transfused during surgery, and the risk of complications was high. These complications included severe postpartum bleeding, shock from blood loss, injury to the bladder or nearby organs, postpartum infection, and blood clots.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">At present, the Department of Obstetrics and Gynecology has established a dedicated multidisciplinary team to care for pregnant women with PAS. The team includes highly experienced surgeons and uses advanced techniques, such as <\/span><b>bilateral internal iliac artery ligation<\/b><span style=\"font-weight: 400;\"> (tying off the major arteries that supply blood to the uterus). Accurate diagnosis before delivery is achieved through detailed ultrasound and MRI examinations. With this approach, more than 100 cases of PAS have been successfully treated, with a low rate of complications. No maternal deaths have occurred, blood loss and blood transfusion rates have been low, and most patients have not required admission to the intensive care unit after surgery.<\/span><\/p>\n<p><b>Conclusion<\/b><\/p>\n<p><span style=\"font-weight: 400;\">Placental Accreta Spectrum is a high-risk condition, often described as a nightmare that obstetricians hope never to encounter. However, maternal illness and death can be reduced when the condition is accurately diagnosed before delivery and when a planned cesarean section is performed by an experienced medical team in a hospital equipped with obstetric surgery, diagnostic imaging, and hematology services.<\/span><\/p>\n<\/div><\/section><\/p><\/div><div  class='flex_column av-72laaer-d8ea37b5b99bba22bb2fe1fb9ab8ef13 av_one_fifth  avia-builder-el-17  el_after_av_three_fifth  el_before_av_one_fifth  flex_column_div  column-top-margin'     ><\/div><div  class='flex_column av-av_one_fifth-2d22dc0500e159f2b39fe7a147caf14c av_one_fifth  avia-builder-el-18  el_after_av_one_fifth  el_before_av_three_fifth  first flex_column_div  column-top-margin'     ><\/div><div  class='flex_column av-av_three_fifth-3b0d446bf9e6f7db91541aa567be4cdf av_three_fifth  avia-builder-el-19  el_after_av_one_fifth  el_before_av_one_fifth  flex_column_div  column-top-margin'     ><div id='av-masonry-1' class='av-masonry 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https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2025\/12\/IMG_3661-773x1030-1-768x1023.jpg 768w, https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2025\/12\/IMG_3661-773x1030-1.jpg 773w\" sizes=\"(max-width: 529px) 100vw, 529px\" \/><\/div><\/div><figcaption class='av-inner-masonry-content site-background'><div class='av-inner-masonry-content-pos'><div class='av-inner-masonry-content-pos-content'><div class='avia-arrow'><\/div><h3 class='av-masonry-entry-title entry-title '  itemprop=\"headline\" >IMG_3661-773&#215;1030<\/h3><\/div><\/div><\/figcaption><\/figure><\/a><!--end av-masonry entry--><a href=\"https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2025\/12\/581890550639886728.jpg\" data-srcset=\"https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2025\/12\/581890550639886728.jpg 762w, https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2025\/12\/581890550639886728-280x300.jpg 280w, https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2025\/12\/581890550639886728-658x705.jpg 658w\" data-sizes=\"(max-width: 762px) 100vw, 762px\"  aria-label=\"image 581890550639886728\"  id='av-masonry-1-item-61989' data-av-masonry-item='61989' class='av-masonry-entry isotope-item post-61989 attachment type-attachment status-inherit hentry  av-masonry-item-with-image' title=\"581890550639886728\" alt=\"\"    itemprop=\"thumbnailUrl\" ><div class='av-inner-masonry-sizer'><\/div><figure class='av-inner-masonry main_color'><div class=\"av-masonry-outerimage-container\"><div class='av-masonry-image-container'  ><img decoding=\"async\" width=\"658\" height=\"705\" fetchpriority=\"high\" class=\"wp-image-61989 avia-img-lazy-loading-not-61989\"  src=\"https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2025\/12\/581890550639886728-658x705.jpg\" title=\"581890550639886728\" alt=\"\" srcset=\"https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2025\/12\/581890550639886728-658x705.jpg 658w, https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2025\/12\/581890550639886728-280x300.jpg 280w, https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2025\/12\/581890550639886728.jpg 762w\" sizes=\"(max-width: 658px) 100vw, 658px\" \/><\/div><\/div><figcaption class='av-inner-masonry-content site-background'><div class='av-inner-masonry-content-pos'><div class='av-inner-masonry-content-pos-content'><div class='avia-arrow'><\/div><h3 class='av-masonry-entry-title entry-title '  itemprop=\"headline\" >581890550639886728<\/h3><\/div><\/div><\/figcaption><\/figure><\/a><!--end av-masonry entry--><a href=\"https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2025\/12\/37322-1030x762-1.jpg\" data-srcset=\"https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2025\/12\/37322-1030x762-1.jpg 1030w, https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2025\/12\/37322-1030x762-1-300x222.jpg 300w, https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2025\/12\/37322-1030x762-1-768x568.jpg 768w, https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2025\/12\/37322-1030x762-1-705x522.jpg 705w\" data-sizes=\"(max-width: 1030px) 100vw, 1030px\"  aria-label=\"image 37322-1030&#215;762\"  id='av-masonry-1-item-61990' data-av-masonry-item='61990' class='av-masonry-entry isotope-item post-61990 attachment type-attachment status-inherit hentry  av-masonry-item-with-image' title=\"37322-1030&#215;762\" alt=\"\"    itemprop=\"thumbnailUrl\" ><div class='av-inner-masonry-sizer'><\/div><figure class='av-inner-masonry main_color'><div class=\"av-masonry-outerimage-container\"><div class='av-masonry-image-container'  ><img decoding=\"async\" width=\"705\" height=\"522\" fetchpriority=\"high\" class=\"wp-image-61990 avia-img-lazy-loading-not-61990\"  src=\"https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2025\/12\/37322-1030x762-1-705x522.jpg\" title=\"37322-1030&#215;762\" alt=\"\" srcset=\"https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2025\/12\/37322-1030x762-1-705x522.jpg 705w, https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2025\/12\/37322-1030x762-1-300x222.jpg 300w, https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2025\/12\/37322-1030x762-1-768x568.jpg 768w, https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2025\/12\/37322-1030x762-1.jpg 1030w\" sizes=\"(max-width: 705px) 100vw, 705px\" \/><\/div><\/div><figcaption class='av-inner-masonry-content site-background'><div class='av-inner-masonry-content-pos'><div class='av-inner-masonry-content-pos-content'><div class='avia-arrow'><\/div><h3 class='av-masonry-entry-title entry-title '  itemprop=\"headline\" >37322-1030&#215;762<\/h3><\/div><\/div><\/figcaption><\/figure><\/a><!--end av-masonry entry--><\/div><\/div><\/div><div  class='flex_column av-av_one_fifth-3b0d446bf9e6f7db91541aa567be4cdf av_one_fifth  avia-builder-el-21  el_after_av_three_fifth  avia-builder-el-last  flex_column_div  column-top-margin'     ><\/div><\/div><\/div><\/div><!-- close content main div --><\/div><\/div><div id='av_section_4'  class='avia-section av-4ybnp2r-f4f15b6e6cfb44fdef504415ca0b375d main_color avia-section-default avia-no-border-styling  avia-builder-el-22  el_after_av_section  avia-builder-el-last  avia-bg-style-scroll container_wrap fullsize'  ><div class='container av-section-cont-open' ><div class='template-page content  av-content-full alpha units'><div class='post-entry post-entry-type-page post-entry-61987'><div class='entry-content-wrapper clearfix'>\n<div  class='flex_column av-49crfxv-ba599245d2023551f9eb9b202a094597 av_one_full  avia-builder-el-23  el_before_av_one_fifth  avia-builder-el-first  first flex_column_div  '     ><style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-43sydbn-87ac92b3e88adefe49162f3f0d8e4224\">\n#top .av_textblock_section.av-43sydbn-87ac92b3e88adefe49162f3f0d8e4224 .avia_textblock{\ntext-align:center;\n}\n<\/style>\n<section  class='av_textblock_section av-43sydbn-87ac92b3e88adefe49162f3f0d8e4224 '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/BlogPosting\" itemprop=\"blogPost\" ><div class='avia_textblock'  itemprop=\"text\" ><h1>Related Highlights<\/h1>\n<\/div><\/section><\/div><div  class='flex_column av-c1ckwj-c87315261c649a9d7b4a4b4db4472675 av_one_fifth  avia-builder-el-25  el_after_av_one_full  el_before_av_three_fifth  first flex_column_div  column-top-margin'     ><\/div><div  class='flex_column av-2xw3ixf-2854137fdef7d339536cde7b1c493226 av_three_fifth  avia-builder-el-26  el_after_av_one_fifth  el_before_av_one_fifth  flex_column_div  column-top-margin'     ><div  id=\"avia-magazine-1\"  class='av-magazine av-2qyebtf-8f42abd21b485c7d0a27f3ca38c11a1c  avia-builder-el-27  avia-builder-el-no-sibling   avia-builder-el-27  avia-builder-el-no-sibling ' ><div class='av-magazine-group sort_all'><article class='av-magazine-entry av-magazine-entry-id-63031 av-magazine-format-standard av-magazine-type-post av-magazine-entry-1 av-magazine-entry-small '  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/BlogPosting\" itemprop=\"blogPost\" ><div class=\"av-magazine-thumbnail\"><a href='https:\/\/www2.si.mahidol.ac.th\/en\/highlights\/hemifacial-spasm-when-less-is-more-adding-value-for-patients-and-the-healthcare-system\/' title='Link to: Hemifacial Spasm: When &#8216;Less&#8217; is &#8216;More&#8217;\u2014Adding Value for Patients and the Healthcare System' class='av-magazine-thumbnail-link'><img decoding=\"async\" fetchpriority=\"high\" width=\"80\" height=\"80\" src=\"https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2026\/04\/cosmetologists-hands-making-medical-botox-injections-beautiful-blonde-skin-lifting-facial-treatment-beauty-spa-copy_0-768x512-1-80x80.jpg\" class=\"wp-image-63033 avia-img-lazy-loading-not-63033 attachment-thumbnail size-thumbnail wp-post-image\" alt=\"\" srcset=\"https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2026\/04\/cosmetologists-hands-making-medical-botox-injections-beautiful-blonde-skin-lifting-facial-treatment-beauty-spa-copy_0-768x512-1-80x80.jpg 80w, https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2026\/04\/cosmetologists-hands-making-medical-botox-injections-beautiful-blonde-skin-lifting-facial-treatment-beauty-spa-copy_0-768x512-1-36x36.jpg 36w, https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2026\/04\/cosmetologists-hands-making-medical-botox-injections-beautiful-blonde-skin-lifting-facial-treatment-beauty-spa-copy_0-768x512-1-180x180.jpg 180w\" sizes=\"(max-width: 80px) 100vw, 80px\" \/><\/a><\/div><div class=\"av-magazine-content-wrap\"><header class=\"entry-content-header\" aria-label=\"Post: Hemifacial Spasm: When &#039;Less&#039; is &#039;More&#039;\u2014Adding Value for Patients and the Healthcare System\"><time class='av-magazine-time updated'  itemprop=\"datePublished\" datetime=\"2026-04-29T09:32:52+07:00\" >April 29, 2026<\/time><h3 class='av-magazine-title entry-title '  itemprop=\"headline\" ><a href='https:\/\/www2.si.mahidol.ac.th\/en\/highlights\/hemifacial-spasm-when-less-is-more-adding-value-for-patients-and-the-healthcare-system\/' title='Link to: Hemifacial Spasm: When &#8216;Less&#8217; is &#8216;More&#8217;\u2014Adding Value for Patients and the Healthcare System'>Hemifacial Spasm: When &#8216;Less&#8217; is &#8216;More&#8217;\u2014Adding Value for Patients and the Healthcare System<\/a><\/h3><\/header><\/div><footer class=\"entry-footer\"><\/footer><\/article><article class='av-magazine-entry av-magazine-entry-id-63022 av-magazine-format-standard av-magazine-type-post av-magazine-entry-2 av-magazine-entry-small '  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/BlogPosting\" itemprop=\"blogPost\" ><div class=\"av-magazine-thumbnail\"><a href='https:\/\/www2.si.mahidol.ac.th\/en\/highlights\/spinal-fracture-surgery-in-the-elderly-treatment-options-for-sustainable-quality-of-life-recovery\/' title='Link to: Spinal Fracture Surgery in the Elderly: Treatment Options for Sustainable Quality of Life Recovery' class='av-magazine-thumbnail-link'><img decoding=\"async\" fetchpriority=\"high\" width=\"80\" height=\"80\" src=\"https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2026\/04\/\u0e1c\u0e48\u0e32\u0e15\u0e31\u0e14\u0e01\u0e23\u0e30\u0e14\u0e39\u0e01\u0e2a\u0e31\u0e19\u0e2b\u0e25\u0e31\u0e07\u0e2b\u0e31\u0e01\u0e43\u0e19\u0e1c\u0e39\u0e49\u0e2a\u0e39\u0e07\u0e2d\u0e32\u0e22\u0e38-1-705x464-1-80x80.jpg\" class=\"wp-image-63023 avia-img-lazy-loading-not-63023 attachment-thumbnail size-thumbnail wp-post-image\" alt=\"\" srcset=\"https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2026\/04\/\u0e1c\u0e48\u0e32\u0e15\u0e31\u0e14\u0e01\u0e23\u0e30\u0e14\u0e39\u0e01\u0e2a\u0e31\u0e19\u0e2b\u0e25\u0e31\u0e07\u0e2b\u0e31\u0e01\u0e43\u0e19\u0e1c\u0e39\u0e49\u0e2a\u0e39\u0e07\u0e2d\u0e32\u0e22\u0e38-1-705x464-1-80x80.jpg 80w, https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2026\/04\/\u0e1c\u0e48\u0e32\u0e15\u0e31\u0e14\u0e01\u0e23\u0e30\u0e14\u0e39\u0e01\u0e2a\u0e31\u0e19\u0e2b\u0e25\u0e31\u0e07\u0e2b\u0e31\u0e01\u0e43\u0e19\u0e1c\u0e39\u0e49\u0e2a\u0e39\u0e07\u0e2d\u0e32\u0e22\u0e38-1-705x464-1-36x36.jpg 36w, https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2026\/04\/\u0e1c\u0e48\u0e32\u0e15\u0e31\u0e14\u0e01\u0e23\u0e30\u0e14\u0e39\u0e01\u0e2a\u0e31\u0e19\u0e2b\u0e25\u0e31\u0e07\u0e2b\u0e31\u0e01\u0e43\u0e19\u0e1c\u0e39\u0e49\u0e2a\u0e39\u0e07\u0e2d\u0e32\u0e22\u0e38-1-705x464-1-180x180.jpg 180w, https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2026\/04\/\u0e1c\u0e48\u0e32\u0e15\u0e31\u0e14\u0e01\u0e23\u0e30\u0e14\u0e39\u0e01\u0e2a\u0e31\u0e19\u0e2b\u0e25\u0e31\u0e07\u0e2b\u0e31\u0e01\u0e43\u0e19\u0e1c\u0e39\u0e49\u0e2a\u0e39\u0e07\u0e2d\u0e32\u0e22\u0e38-1-705x464-1-327x321.jpg 327w\" sizes=\"(max-width: 80px) 100vw, 80px\" \/><\/a><\/div><div class=\"av-magazine-content-wrap\"><header class=\"entry-content-header\" aria-label=\"Post: Spinal Fracture Surgery in the Elderly: Treatment Options for Sustainable Quality of Life Recovery\"><time class='av-magazine-time updated'  itemprop=\"datePublished\" datetime=\"2026-04-28T14:27:08+07:00\" >April 28, 2026<\/time><h3 class='av-magazine-title entry-title '  itemprop=\"headline\" ><a href='https:\/\/www2.si.mahidol.ac.th\/en\/highlights\/spinal-fracture-surgery-in-the-elderly-treatment-options-for-sustainable-quality-of-life-recovery\/' title='Link to: Spinal Fracture Surgery in the Elderly: Treatment Options for Sustainable Quality of Life Recovery'>Spinal Fracture Surgery in the Elderly: Treatment Options for Sustainable Quality of Life Recovery<\/a><\/h3><\/header><\/div><footer class=\"entry-footer\"><\/footer><\/article><article class='av-magazine-entry av-magazine-entry-id-62017 av-magazine-format-standard av-magazine-type-post av-magazine-entry-3 av-magazine-entry-small '  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/BlogPosting\" itemprop=\"blogPost\" ><div class=\"av-magazine-thumbnail\"><a href='https:\/\/www2.si.mahidol.ac.th\/en\/highlights\/development-of-a-retrobulbar-anesthesia-injection-training-simulator\/' title='Link to: Development of a Retrobulbar Anesthesia Injection Training Simulator' class='av-magazine-thumbnail-link'><img decoding=\"async\" fetchpriority=\"high\" width=\"80\" height=\"80\" src=\"https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2025\/12\/IMG_7721-1_0_0-1-80x80.jpg\" class=\"wp-image-62018 avia-img-lazy-loading-not-62018 attachment-thumbnail size-thumbnail wp-post-image\" alt=\"\" srcset=\"https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2025\/12\/IMG_7721-1_0_0-1-80x80.jpg 80w, https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2025\/12\/IMG_7721-1_0_0-1-36x36.jpg 36w, https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2025\/12\/IMG_7721-1_0_0-1-180x180.jpg 180w\" sizes=\"(max-width: 80px) 100vw, 80px\" \/><\/a><\/div><div class=\"av-magazine-content-wrap\"><header class=\"entry-content-header\" aria-label=\"Post: Development of a Retrobulbar Anesthesia Injection Training Simulator\"><time class='av-magazine-time updated'  itemprop=\"datePublished\" datetime=\"2025-12-23T09:01:25+07:00\" >December 23, 2025<\/time><h3 class='av-magazine-title entry-title '  itemprop=\"headline\" ><a href='https:\/\/www2.si.mahidol.ac.th\/en\/highlights\/development-of-a-retrobulbar-anesthesia-injection-training-simulator\/' title='Link to: Development of a Retrobulbar Anesthesia Injection Training Simulator'>Development of a Retrobulbar Anesthesia Injection Training Simulator<\/a><\/h3><\/header><\/div><footer class=\"entry-footer\"><\/footer><\/article><article class='av-magazine-entry av-magazine-entry-id-61978 av-magazine-format-standard av-magazine-type-post av-magazine-entry-4 av-magazine-entry-small '  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/BlogPosting\" itemprop=\"blogPost\" ><div class=\"av-magazine-thumbnail\"><a href='https:\/\/www2.si.mahidol.ac.th\/en\/highlights\/sleep-surgery-clinic-digital-sleep-surgical-services-dsss\/' title='Link to: Sleep Surgery Clinic (Digital Sleep Surgical Services: DSSS)' class='av-magazine-thumbnail-link'><img decoding=\"async\" fetchpriority=\"high\" width=\"80\" height=\"80\" src=\"https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2025\/12\/in-the-hospital-2025-01-29-09-05-18-utc-80x80.jpg\" class=\"wp-image-61979 avia-img-lazy-loading-not-61979 attachment-thumbnail size-thumbnail wp-post-image\" alt=\"\" srcset=\"https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2025\/12\/in-the-hospital-2025-01-29-09-05-18-utc-80x80.jpg 80w, https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2025\/12\/in-the-hospital-2025-01-29-09-05-18-utc-36x36.jpg 36w, https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2025\/12\/in-the-hospital-2025-01-29-09-05-18-utc-180x180.jpg 180w\" sizes=\"(max-width: 80px) 100vw, 80px\" \/><\/a><\/div><div class=\"av-magazine-content-wrap\"><header class=\"entry-content-header\" aria-label=\"Post: Sleep Surgery Clinic (Digital Sleep Surgical Services: DSSS)\"><time class='av-magazine-time updated'  itemprop=\"datePublished\" datetime=\"2025-12-19T10:15:08+07:00\" >December 19, 2025<\/time><h3 class='av-magazine-title entry-title '  itemprop=\"headline\" ><a href='https:\/\/www2.si.mahidol.ac.th\/en\/highlights\/sleep-surgery-clinic-digital-sleep-surgical-services-dsss\/' title='Link to: Sleep Surgery Clinic (Digital Sleep Surgical Services: DSSS)'>Sleep Surgery Clinic (Digital Sleep Surgical Services: DSSS)<\/a><\/h3><\/header><\/div><footer class=\"entry-footer\"><\/footer><\/article><article class='av-magazine-entry av-magazine-entry-id-60965 av-magazine-format-standard av-magazine-type-post av-magazine-entry-5 av-magazine-entry-small '  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/BlogPosting\" itemprop=\"blogPost\" ><div class=\"av-magazine-thumbnail\"><a href='https:\/\/www2.si.mahidol.ac.th\/en\/highlights\/innovation-in-brain-cancer-diagnosis-dna-and-epigenome-analysis\/' title='Link to: Innovation in Brain Cancer Diagnosis: DNA and Epigenome Analysis' class='av-magazine-thumbnail-link'><img decoding=\"async\" fetchpriority=\"high\" width=\"80\" height=\"80\" src=\"https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2025\/11\/1763101741942-80x80.jpg\" class=\"wp-image-60966 avia-img-lazy-loading-not-60966 attachment-thumbnail size-thumbnail wp-post-image\" alt=\"\" srcset=\"https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2025\/11\/1763101741942-80x80.jpg 80w, https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2025\/11\/1763101741942-36x36.jpg 36w, https:\/\/www2.si.mahidol.ac.th\/en\/wp-content\/uploads\/2025\/11\/1763101741942-180x180.jpg 180w\" sizes=\"(max-width: 80px) 100vw, 80px\" \/><\/a><\/div><div class=\"av-magazine-content-wrap\"><header class=\"entry-content-header\" aria-label=\"Post: Innovation in Brain Cancer Diagnosis: DNA and Epigenome Analysis\"><time class='av-magazine-time updated'  itemprop=\"datePublished\" datetime=\"2025-11-20T21:59:05+07:00\" >November 20, 2025<\/time><h3 class='av-magazine-title entry-title '  itemprop=\"headline\" ><a href='https:\/\/www2.si.mahidol.ac.th\/en\/highlights\/innovation-in-brain-cancer-diagnosis-dna-and-epigenome-analysis\/' title='Link to: Innovation in Brain Cancer Diagnosis: DNA and Epigenome Analysis'>Innovation in Brain Cancer Diagnosis: DNA and Epigenome Analysis<\/a><\/h3><\/header><\/div><footer class=\"entry-footer\"><\/footer><\/article><\/div><\/div><\/div><div  class='flex_column av-84pztf-9e3fa3f4d1489953498cc7498dc6b310 av_one_fifth  avia-builder-el-28  el_after_av_three_fifth  el_before_av_one_fifth  flex_column_div  column-top-margin'     ><\/div><div  class='flex_column av-1s9hc4z-5b784899e9ba358504e6d52b06414e89 av_one_fifth  avia-builder-el-29  el_after_av_one_fifth  el_before_av_three_fifth  first flex_column_div  column-top-margin'     ><\/div><div  class='flex_column av-175fd9v-4422b88f0f99f2940fd7259d1ecbc797 av_three_fifth  avia-builder-el-30  el_after_av_one_fifth  el_before_av_one_fifth  flex_column_div  column-top-margin'     ><div  class='avia-button-wrap avia-button-center  avia-builder-el-31  avia-builder-el-no-sibling '>\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-mha7xxzp-98b85d2dfdaf2dc498d81862caabb425\">\n#top #wrap_all 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