title: Placenta accreta spectrum: accreta, increta, and percreta.
abstract: Placenta 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.
authors.affiliation: 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.
authors.forename: Robert M
authors.initials: RM
authors.lastname: Silver
authors.affiliation: 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. Electronic address: kelli.barbour@hsc.utah.edu.
authors.forename: Kelli D
authors.initials: KD
authors.lastname: Barbour
mesh_terms: D000328:Adult; D001803:Blood Transfusion / Q000706:statistics & numerical data; D002585:Cesarean Section / Q000009:adverse effects* / Q000706:statistics & numerical data; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000706:statistics & numerical data*; D015994:Incidence; D007231:Infant, Newborn; D010921:Placenta Accreta / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000517:prevention & control; D010923:Placenta Previa / Q000601:surgery*; D006473:Postpartum Hemorrhage / Q000175:diagnosis* / Q000000981:diagnostic imaging* / Q000517:prevention & control; D011247:Pregnancy; D012307:Risk Factors; D016896:Treatment Outcome; D016216:Ultrasonography, Prenatal
keywords: Abnormal placentation; Accreta; Cesarean hysterectomy; Hemorrhage; Increta; Indicated preterm delivery; Percreta; Placenta