title: Multiple repeat cesareans and the threat of placenta accreta: incidence, diagnosis, management.
abstract: Placenta accreta is a significant source of obstetric morbidity and mortality. Its incidence is increasing as a direct consequence of the increasing cesarean section rate, which reflects increased rates of maternal obesity, increased numbers of multiple gestations secondary to assisted reproductive technology, physician concern about litigation for adverse obstetric outcome, and a decline in the use of operative vaginal delivery for both cephalic and breech presentations. Optimum management for most cases requires elective cesarean hysterectomy, ideally performed at about 34 weeks' gestation. A multidisciplinary approach produces the best outcomes.
authors.affiliation: Division of Perinatal Medicine, Department of Reproductive Medicine, University of California San Diego, San Diego, CA 92103-8433, USA.
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Hull
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Moore
mesh_terms: D000328:Adult; D000367:Age Factors; D017604:Cesarean Section, Repeat / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008423:Maternal Age; D010921:Placenta Accreta / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D011247:Pregnancy; D012307:Risk Factors; D013223:Statistics as Topic; D014463:Ultrasonography