Prenatal Diagnosis and Perinatal Management of Placenta Previa Accreta: Past, Present and Future

The reported incidence of placenta accrete varies widely in the English literature, from 1 :540 to 1 :93,000 deliveries. In Taiwan, the quoted incidence ranges from 1 :625 to 1:1 ,652 deliveries in tertiary medical centers. Massive obstetric hemorrhage is still the leading cause of pregnancy-related death, and placenta previa accrete remains one of the major predisposing factors. With the increasing rates of cesarean delivery and uterine curettage for abortion, both placenta previa and accrete are steadily increasing in frequency. Therefore, more cases of placenta previa accrete can be expected in obstetric practice. In several recent series, placenta accrete has emerged as the major indication for peripartum hysterectomy, accounting for 40% to 60% of cases. It has, therefore, become a challenging problem of increasing clinical significance in obstetrics. [Taiwanese J Obstet Gynecol 2004;43(2):64-71)