• Obstet. Gynecol. Clin. North Am. · Jun 2015

    Review

    Placenta accreta spectrum: accreta, increta, and percreta.

    • Robert M Silver and Kelli D Barbour.
    • Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, University of Utah Health Sciences Center, 30 North 1900 East 2B200 SOM, Salt Lake City, UT 84132, USA.
    • Obstet. Gynecol. Clin. North Am. 2015 Jun 1; 42 (2): 381-402.

    AbstractPlacenta accreta can lead to hemorrhage, resulting in hysterectomy, blood transfusion, multiple organ failure, and death. Accreta has been increasing steadily in incidence owing to an increase in the cesarean delivery rate. Major risk factors are placenta previa in women with prior cesarean deliveries. Obstetric ultrasonography can be used to diagnose placenta accreta antenatally, which allows for scheduled delivery in a multidisciplinary center of excellence for accreta. Controversies exist regarding optimal management, including optimal timing of delivery, surgical approach, use of adjunctive measures, and conservative (uterine-sparing) therapy. We review the definition, risk factors, diagnosis, management, and controversies regarding placenta accreta. Copyright © 2015 Elsevier Inc. All rights reserved.

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