No. 383-Screening, Diagnosis, and Management of Placenta Accreta Spectrum Disorders



      Placenta accreta spectrum (PAS) disorders are a potentially life-threatening complication of pregnancy that demand coordinated interdisciplinary care to achieve safer outcomes. The rising incidence of this disease is due to a growing number of uterine surgical procedures, including the rising incidence of pregnancy following Caesarean section.


      To provide current evidence-based guidelines on the optimal methods used to effectively screen, diagnose, and manage PAS disorders.


      Members of the guideline committee were selected on the basis of their ongoing expertise in managing this condition across Canada and by practice setting. The committee reviewed all available evidence in the English medical literature, including published guidelines, and evaluated diagnostic tests, surgical procedures, and clinical outcomes.


      Published literature, including clinical practice guidelines, was retrieved through searches of Medline and The Cochrane Library to March 2018 using appropriate controlled vocabulary and key words. Results were restricted to systematic reviews, randomized controlled trials, and observational studies written in English. Searches were updated on a regular basis and incorporated in the guideline to July 2018.


      The quality of evidence in this document was graded using the criteria described in the Report of the Canadian Task Force on Preventive Health Care.


      This document reviews the evidence regarding the available diagnostic and surgical techniques used for optimal management of women with suspected PAS disorders, including anaesthesia and practical considerations for interdisciplinary care.

      Benefits, Harms, and Costs

      Implementation of the guideline recommendations will improve awareness of this disease and increase the proportion of affected women receiving interdisciplinary care in regional centres.


      Interdisciplinary team-based care providing accurate diagnostic services, coordinated planning, and safer surgery deliver effective care with improved clinical outcomes in comparison with alternative management.

      Summary Statements

      • 1
        The incidence of placenta accreta spectrum disorders is steadily rising in many countries, likely due to the increasing proportion of women becoming pregnant following a variety of surgical procedures to the uterus, including multiple Caesarean sections.
      • 2
        Placenta accreta spectrum disorders in the setting of prior Caesarean section deliveries arises from pregnancy implantation within the niche created by this surgery near the cervicoisthmic junction of the uterus. This early presentation as a “Caesarean section scar pregnancy” may be diagnosed by ultrasound methods.
      • 3
        Ultrasound may be used to screen for, and to diagnose, pregnancies with anterior placenta previa that are complicated by placenta accreta spectrum disorders. The effectiveness of ultrasound in this context depends upon awareness of clinical risk factors, imaging quality, operator experience, gestational age, imaging modalities, and adequate bladder filling.
      • 4
        Magnetic resonance imaging may complement multimodal ultrasound in the diagnosis and staging of placenta accreta spectrum disorders, though its effectiveness is currently limited by the relative contraindication to the use of a gadolinium contrast enhancing agent.
      • 5
        Placenta accreta spectrum disorders are potentially life-threatening and demand regional interdisciplinary team-based care to deliver the safest outcomes for mothers and infants.


      • 1
        Pregnant women with clinical risk factors for placenta accreta spectrum disorders and anterior placenta previa at the 18–20-week fetal anatomical ultrasound should be referred for specialist imaging to diagnose or exclude this disorder (II-2A).
      • 2
        Women with a diagnosis of placenta accreta spectrum disorder should be referred to a regional centre dedicated to the interdisciplinary management of this condition (II-3A).
      • 3
        Protocol-based interdisciplinary care from diagnosis to surgery will optimize both intraoperative and postoperative outcomes (II-3A).
      • 4
        Antenatal admission to a designated regional management centre may be indicated, especially following an antepartum hemorrhage, or based on considerations of geography or transport conditions (III-B).
      • 5
        For otherwise healthy women with no history of vaginal bleeding, the optimal timing of elective Caesarean section delivery is around 34–36 weeks gestation (II-3B). Surgery should be considered earlier for repeated episodes of antepartum hemorrhage or contractions to reduce the risks of emergent unplanned surgery and should ideally be preceded by a course of corticosteroids to enhance fetal lung maturation if prior to 35+0 weeks gestation (II-2A).
      • 6
        Regional anaesthesia may be safer than general anaesthesia as it is associated with reduced blood loss and is preferred by patients and their partners (II-2A). A massive transfusion protocol should be in place to respond to significant blood loss (III-B).
      • 7
        Intravenous tranexamic acid should be administered at the commencement of surgery because it reduces intraoperative blood loss (I-A).
      • 8
        Surgery should be performed in the modified lithotomy position, using midline access, sufficiently high so as to deliver the fetus without incising through the placenta; preoperative or intraoperative ultrasound can be used to guide the optimal uterine incision (III-B). No attempt should be made to remove the placenta if it shows no signs of separation as this may cause substantial hemorrhage (III-B).
      • 9
        Presently there is insufficient evidence to recommend giving or withholding uterotonic drugs after delivery of the fetus (III-C).
      • 10
        Presently there is insufficient evidence to recommend either approach (preoperative balloon placement or intraoperative ligation) designed to arrest blood flow from the internal iliac arteries prior to hysterectomy (II-1C).
      • 11
        Focal central disease may be amenable to wedge resection, with complete removal of the placenta and repair of the uterus (the triple-P procedure) (II-3B).
      • 12
        Classical Caesarean section and non-removal of the invasive placenta is an acceptable method of delivery but is associated with a protracted course of recovery and a persistent risk of hysterectomy (II-3B).
      • 13
        Women who retain their fertility following a diagnosis of placenta accreta spectrum disorder should be instructed to access specialist ultrasound early in any future pregnancy so that all management options are available should a Caesarean section scar pregnancy be found (III-B).
      • 14
        Prenatal diagnosis of the more severe forms of placenta accreta spectrum disorder, expressed as a Caesarean section scar pregnancy, may permit management using minimally invasive surgical techniques (II-3B).
      • 15
        Though many women with placenta accreta spectrum disorder in well-resourced countries receive safe care, more research and knowledge translation are needed to effectively deliver all management options at the population-based level (III-B).

      Key Words

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        • Warshak CR
        • Ramos GA
        • Eskander R
        • et al.
        Effect of predelivery diagnosis in 99 consecutive cases of placenta accreta.
        Obstet Gynecol. 2010; 115: 65-69
        • Baldwin HJ
        • Patterson JA
        • Nippita TA
        • et al.
        Maternal and neonatal outcomes following abnormally invasive placenta: a population-based record linkage study.
        Acta Obstet Gynecol Scand. 2017; 96: 1373-1381
        • Wu S
        • Kocherginsky M
        • Hibbard JU
        Abnormal placentation: twenty-year analysis.
        Am J Obstet Gynecol. 2005; 192: 1458-1461
        • Thurn L
        • Lindqvist PG
        • Jakobsson M
        • et al.
        Abnormally invasive placenta-prevalence, risk factors and antenatal suspicion: results from a large population-based pregnancy cohort study in the Nordic countries.
        BJOG. 2016; 123: 1348-1355
        • Fitzpatrick KE
        • Sellers S
        • Spark P
        • et al.
        Incidence and risk factors for placenta accreta/increta/percreta in the UK: a national case-control study.
        PLoS One. 2012; 7: e52893
        • Betran AP
        • Ye J
        • Moller AB
        • et al.
        The increasing trend in caesarean section rates: Global, regional and national estimates: 1990-2014.
        PLoS One. 2016; 11e0148343
        • Sumigama S
        • Sugiyama C
        • Kotani T
        • et al.
        Uterine sutures at prior caesarean section and placenta accreta in subsequent pregnancy: a case-control study.
        BJOG. 2014; 121 (discussion 75): 866-874
        • Roberge S
        • Demers S
        • Girard M
        • et al.
        Impact of uterine closure on residual myometrial thickness after cesarean: a randomized controlled trial.
        Am J Obstet Gynecol. 2016; 214 (507.e1–6)
        • Silver RM
        Placenta accreta syndrome. Portland, OR: CRC Press.
        Taylor & Francis Group. 2017; : 5-6
        • Pekar-Zlotin M
        • Melcer Y
        • Maymon R
        • et al.
        Second-trimester levels of fetoplacental hormones among women with placenta accreta spectrum disorders.
        Int J Gynaecol Obstet. 2018; 140: 377-378
        • Thompson O
        • Otigbah C
        • Nnochiri A
        • et al.
        First trimester maternal serum biochemical markers of aneuploidy in pregnancies with abnormally invasive placentation.
        BJOG. 2015; 122: 1370-1376
        • Lyell DJ
        • Faucett AM
        • Baer RJ
        • et al.
        Maternal serum markers, characteristics and morbidly adherent placenta in women with previa.
        J Perinatol. 2015; 35: 570-574
        • Kupferminc MJ
        • Tamura RK
        • Wigton TR
        • et al.
        Placenta accreta is associated with elevated maternal serum alpha-fetoprotein.
        Obstet Gynecol. 1993; 82: 266-269
        • Ash A
        • Smith A
        • Maxwell D
        Caesarean scar pregnancy.
        BJOG. 2007; 114: 253-263
        • Vial Y
        • Petignat P
        • Hohlfeld P
        Pregnancy in a cesarean scar.
        Ultrasound Obstet Gynecol. 2000; 16: 592-593
        • Graesslin O
        • Dedecker F Jr
        • Quereux C
        • et al.
        Conservative treatment of ectopic pregnancy in a cesarean scar.
        Obstet Gynecol. 2005; 105: 869-871
        • Ginath S
        • Malinger G
        • Golan A
        • et al.
        Successful laparoscopic treatment of a ruptured primary abdominal pregnancy.
        Fertil Steril. 2000; 74: 601-602
        • Timor-Tritsch IE
        • Monteagudo A
        • Cali G
        • et al.
        Cesarean scar pregnancy is a precursor of morbidly adherent placenta.
        Ultrasound Obstet Gynecol. 2014; 44: 346-353
        • Reddy UM
        • Abuhamad AZ
        • Levine D
        • et al.
        Fetal imaging: executive summary of a Joint Eunice Kennedy Shriver National Institute of Child Health and Human Development, Society for Maternal-Fetal Medicine, American Institute of Ultrasound in Medicine, American College of Obstetricians and Gynecologists, American College of Radiology, Society for Pediatric Radiology, and Society of Radiologists in Ultrasound Fetal Imaging Workshop.
        Am J Obstet Gynecol. 2014; 210: 387-397
        • Melcer Y
        • Jauniaux E
        • Maymon S
        • et al.
        Impact of targeted scanning protocols on perinatal outcomes in pregnancies at risk of placenta accreta spectrum or vasa previa.
        Am J Obstet Gynecol. 2018; 218 (443.e1–8)
        • D'Antonio F
        • Iacovella C
        • Bhide A
        Prenatal identification of invasive placentation using ultrasound: systematic review and meta-analysis.
        Ultrasound Obstet Gynecol. 2013; 42: 509-517
        • Kocher MR
        • Sheafor DH
        • Bruner E
        • et al.
        Diagnosis of abnormally invasive posterior placentation: the role of MR imaging.
        Radiol Case Rep. 2017; 12: 295-299
        • Aitken K
        • Cram J
        • Raymond E
        • et al.
        “Mobile” medicine: a surprise encounter with placenta percreta.
        J Obstet Gynaecol Can. 2014; 36: 377
        • Patenaude Y
        • Pugash D
        • Lim K
        • et al.
        The use of magnetic resonance imaging in the obstetric patient.
        J Obstet Gynaecol Can. 2014; 36: 349-355
        • Ray JG
        • Vermeulen MJ
        • Bharatha A
        • et al.
        Association between MRI exposure during pregnancy and fetal and childhood outcomes.
        JAMA. 2016; 316: 952-961
        • Kilcoyne A
        • Shenoy-Bhangle AS
        • Roberts DJ
        • et al.
        MRI of placenta accreta, placenta increta, and placenta percreta: pearls and pitfalls.
        AJR Am J Roentgenol. 2017; 208: 214-221
        • Millischer AE
        • Salomon LJ
        • Porcher R
        • et al.
        Magnetic resonance imaging for abnormally invasive placenta: the added value of intravenous gadolinium injection.
        BJOG. 2017; 124: 88-95
        • D'Antonio F
        • Iacovella C
        • Palacios-Jaraquemada J
        • et al.
        Prenatal identification of invasive placentation using magnetic resonance imaging: systematic review and meta-analysis.
        Ultrasound Obstet Gynecol. 2014; 44: 8-16
        • Einerson BD
        • Rodriguez CE
        • Kennedy AM
        • et al.
        Magnetic resonance imaging is often misleading when used as an adjunct to ultrasound in the management of placenta accreta spectrum disorders.
        Am J Obstet Gynecol. 2018; 218 (618.e1–7)
        • Familiari A
        • Liberati M
        • Lim P
        • et al.
        Diagnostic accuracy of magnetic resonance imaging in detecting the severity of abnormal invasive placenta: a systematic review and meta-analysis.
        Acta Obstet Gynecol Scand. 2018; 97: 507-520
        • Walker MG
        • Allen L
        • Windrim RC
        • et al.
        Multidisciplinary management of invasive placenta previa.
        J Obstet Gynaecol Can. 2013; 35: 417-425
        • Shamshirsaz AA
        • Fox KA
        • Erfani H
        • Clark SL
        • et al.
        Outcomes of planned compared with urgent deliveries using a multidisciplinary team approach for morbidly adherent placenta.
        Obstet Gynecol. 2018; 131: 234-241
        • Grace Tan SE
        • Jobling TW
        • et al.
        Surgical management of placenta accreta: a 10-year experience.
        Acta Obstet Gynecol Scand. 2013; 92: 445-450
        • Hantoushzadeh S
        • Yazdi HR
        • Borna S
        • et al.
        Multidisciplinary approach in management of placenta accreta.
        Taiwan J Obstet Gynecol. 2011; 50: 114-117
        • Eller AG
        • Bennett MA
        • Sharshiner M
        • et al.
        Maternal morbidity in cases of placenta accreta managed by a multidisciplinary care team compared with standard obstetric care.
        Obstet Gynecol. 2011; 117: 331-337
        • Al-Khan A
        • Gupta V
        • Illsley NP
        • et al.
        Maternal and fetal outcomes in placenta accreta after institution of team-managed care.
        Reprod Sci. 2014; 21: 761-771
        • Smulian JC
        • Pascual AL
        • Hesham H
        • et al.
        Invasive placental disease: the impact of a multi-disciplinary team approach to management.
        J Matern Fetal Neonatal Med. 2017; 30: 1423-1427
        • Shamshirsaz AA
        • Fox KA
        • Erfani H
        • et al.
        Multidisciplinary team learning in the management of the morbidly adherent placenta: outcome improvements over time.
        Am J Obstet Gynecol. 2017; 216 (612.e1–5)
        • Moawad G
        • Tyan P
        • Corpodean F
        • et al.
        Ethical considerations arising from surgeon caseload volume in benign gynecologic surgery.
        J Minim Invasive Gynecol. 2018; 25: 749-751
        • Mowat A
        • Maher C
        • Ballard E
        Surgical outcomes for low-volume vs high-volume surgeons in gynecology surgery: a systematic review and meta-analysis.
        Am J Obstet Gynecol. 2016; 215: 21-33
        • Walker MG
        • Pollard L
        • Talati C
        • et al.
        Obstetric and anaesthesia checklists for the management of morbidly adherent placenta.
        J Obstet Gynaecol Can. 2016; 38: 1015-1023
        • Committee on Obstetric Practice
        Committee opinion no. 529: placenta accreta.
        Obstet Gynecol. 2012; 120: 207-211
        • Nguyen-Lu N
        • Carvalho JC
        • Kingdom J
        • et al.
        Mode of anesthesia and clinical outcomes of patients undergoing Cesarean delivery for invasive placentation: a retrospective cohort study of 50 consecutive cases.
        Can J Anaesth. 2016; 63: 1233-1244
        • Taylor NJ
        • Russell R
        Anaesthesia for abnormally invasive placenta: a single-institution case series.
        Int J Obstet Anesth. 2017; 30: 10-15
        • Chandraharan E
        • Rao S
        • Belli AM
        • et al.
        The Triple-P procedure as a conservative surgical alternative to peripartum hysterectomy for placenta percreta.
        Int J Gynaecol Obstet. 2012; 117: 191-194
        • Eller AG
        • Porter TF
        • Soisson P
        • et al.
        Optimal management strategies for placenta accreta.
        BJOG. 2009; 116: 648-654
        • Seoud MA
        • Nasr R
        • Berjawi GA
        • et al.
        Placenta accreta: elective versus emergent delivery as a major predictor of blood loss.
        J Neonatal Perinatal Med. 2017; 10: 9-15
        • Bowman ZS
        • Manuck TA
        • Eller AG
        • et al.
        Risk factors for unscheduled delivery in patients with placenta accreta.
        Am J Obstet Gynecol. 2014; 210 (241.e1–6)
        • Shamshirsaz AA
        • Fox KA
        • Salmanian B
        • et al.
        Maternal morbidity in patients with morbidly adherent placenta treated with and without a standardized multidisciplinary approach.
        Am J Obstet Gynecol. 2015; 212 (218.e1–9)
        • Skoll A
        • Boutin A
        • Bujold E
        • et al.
        No. 364-antenatal corticosteroid therapy for improving neonatal outcomes.
        J Obstet Gynaecol Can. 2018; 40: 1219-1239
        • Rac MW
        • Wells CE
        • Twickler DM
        • et al.
        Placenta accreta and vaginal bleeding according to gestational age at delivery.
        Obstet Gynecol. 2015; 125: 808-813
        • Robinson BK
        • Grobman WA
        Effectiveness of timing strategies for delivery of individuals with placenta previa and accreta.
        Obstet Gynecol. 2010; 116: 835-842
        • Singh SS
        • Mehra N
        • Hopkins L
        No. 286-surgical safety checklist in obstetrics and gynaecology.
        J Obstet Gynaecol Can. 2018; 40: e237-e242
        • Committee on Practice Bulletins—Gynecology, American College of Obstetricians and Gynecologists
        ACOG practice bulletin no. 84: prevention of deep vein thrombosis and pulmonary embolism.
        Obstet Gynecol. 2007; 110: 429-440
        • Bratzler DW
        • Dellinger EP
        • Olsen KM
        • et al.
        Clinical practice guidelines for antimicrobial prophylaxis in surgery.
        Am J Health Syst Pharm. 2013; 70: 195-283
        • Shakur H
        • Beaumont D
        • Pavord S
        • et al.
        Antifibrinolytic drugs for treating primary postpartum haemorrhage.
        Cochrane Database Syst Rev. 2018; CD012964
        • Allen L
        • Jauniaux E
        • Hobson S
        • et al.
        FIGO consensus guidelines on placenta accreta spectrum disorders: Nonconservative surgical management.
        Int J Gynaecol Obstet. 2018; 140: 281-290
        • Norris BL
        • Everaerts W
        • Posma E
        • et al.
        The urologist's role in multidisciplinary management of placenta percreta.
        BJU Int. 2016; 117: 961-965
        • Elagamy A
        • Abdelaziz A
        • Ellaithy M
        The use of cell salvage in women undergoing cesarean hysterectomy for abnormal placentation.
        Int J Obstet Anesth. 2013; 22: 289-293
      1. Hussein AM, Dakhly DMR, Raslan AN, et al. The role of prophylactic internal iliac artery ligation in abnormally invasive placenta undergoing caesarean hysterectomy: a randomized control trial. J Matern Fetal Neonatal Med 2018:1–7.

        • Salim R
        • Chulski A
        • Romano S
        • et al.
        Precesarean prophylactic balloon catheters for suspected placenta accreta: a randomized controlled trial.
        Obstet Gynecol. 2015; 126: 1022-1028
        • Petrov DA
        • Karlberg B
        • Singh K
        • et al.
        Perioperative internal iliac artery balloon occlusion, in the setting of placenta accreta and its variants: the role of the interventional radiologist.
        Curr Probl Diagn Radiol. 2018; 47: 445-451
        • Iwata A
        • Murayama Y
        • Itakura A
        • et al.
        Limitations of internal iliac artery ligation for the reduction of intraoperative hemorrhage during cesarean hysterectomy in cases of placenta previa accreta.
        J Obstet Gynaecol Res. 2010; 36: 254-259
        • Shrivastava V
        • Nageotte M
        • Major C
        • et al.
        Case-control comparison of cesarean hysterectomy with and without prophylactic placement of intravascular balloon catheters for placenta accreta.
        Am J Obstet Gynecol. 2007; 197 (402.e1–5)
        • Duan XH
        • Wang YL
        • Han XW
        • et al.
        Caesarean section combined with temporary aortic balloon occlusion followed by uterine artery embolisation for the management of placenta accreta.
        Clin Radiol. 2015; 70: 932-937
        • Panici PB
        • Anceschi M
        • Borgia ML
        • et al.
        Intraoperative aorta balloon occlusion: fertility preservation in patients with placenta previa accreta/increta.
        J Matern Fetal Neonatal Med. 2012; 25: 2512-2516
        • Wu Q
        • Liu Z
        • Zhao X
        • et al.
        Outcome of pregnancies after balloon occlusion of the infrarenal abdominal aorta during caesarean in 230 patients with placenta praevia accreta.
        Cardiovasc Intervent Radiol. 2016; 39: 1573-1579
        • Zhu B
        • Yang K
        • Cai L
        Discussion on the timing of balloon occlusion of the abdominal aorta during a caesarean section in patients with pernicious placenta previa complicated with placenta accreta.
        Biomed Res Int. 2017; 20178604849
        • Luo F
        • Xie L
        • Xie P
        • et al.
        Intraoperative aortic balloon occlusion in patients with placenta previa and/or placenta accreta: a retrospective study.
        Taiwan J Obstet Gynecol. 2017; 56: 147-152
        • Ordonez CA
        • Manzano-Nunez R
        • Parra MW
        • et al.
        Prophylactic use of resuscitative endovascular balloon occlusion of the aorta in women with abnormal placentation: a systematic review, meta-analysis, and case series.
        J Trauma Acute Care Surg. 2018; 84: 809-818
        • Palacios Jaraquemada JM
        • Pesaresi M
        • et al.
        Anterior placenta percreta: surgical approach, hemostasis and uterine repair.
        Acta Obstet Gynecol Scand. 2004; 83: 738-744
        • Aitken K
        • Allen L
        • Pantazi S
        • et al.
        MRI significantly improves disease staging to direct surgical planning for abnormal invasive placentation: a single centre experience.
        J Obstet Gynaecol Can. 2016; 38: 246-251
        • Tskhay VB
        The use of modified triple-p method with adherent placenta long-term results.
        Womens Health. 2017; 4: 30-32
        • Sentilhes L
        • Kayem G
        • Chandraharan E
        • et al.
        FIGO consensus guidelines on placenta accreta spectrum disorders: Conservative management.
        Int J Gynaecol Obstet. 2018; 140: 291-298
        • Amsalem H
        • Kingdom JCP
        • Farine D
        • et al.
        Planned caesarean hysterectomy versus "conserving" caesarean section in patients with placenta accreta.
        J Obstet Gynaecol Can. 2011; 33: 1005-1010
        • Pather S
        • Strockyj S
        • Richards A
        • et al.
        Maternal outcome after conservative management of placenta percreta at caesarean section: a report of three cases and a review of the literature.
        Aust N Z J Obstet Gynaecol. 2014; 54: 84-87
        • Legendre G
        • Zoulovits FJ
        • Kinn J
        • et al.
        Conservative management of placenta accreta: hysteroscopic resection of retained tissues.
        J Minim Invasive Gynecol. 2014; 21: 910-913
        • Arendas K
        • Lortie KJ
        • Singh SS
        Delayed laparoscopic management of placenta increta.
        J Obstet Gynaecol Can. 2012; 34: 186-189
        • Rupley DM
        • Tergas AI
        • Palmerola KL
        • et al.
        Robotically assisted delayed total laparoscopic hysterectomy for placenta percreta.
        Gynecol Oncol Rep. 2016; 17: 53-55
        • El-Messidi A
        • Mallozzi A
        • Oppenheimer L
        A multidisciplinary checklist for management of suspected placenta accreta.
        J Obstet Gynaecol Can. 2012; 34: 320-324
        • Sentilhes L
        • Kayem G
        • Ambroselli C
        • et al.
        Fertility and pregnancy outcomes following conservative treatment for placenta accreta.
        Hum Reprod. 2010; 25: 2803-2810
        • Provansal M
        • Courbiere B
        • Agostini A
        • et al.
        Fertility and obstetric outcome after conservative management of placenta accreta.
        Int J Gynaecol Obstet. 2010; 109: 147-150
        • Kabiri D
        • Hants Y
        • Shanwetter N
        • et al.
        Outcomes of subsequent pregnancies after conservative treatment for placenta accreta.
        Int J Gynaecol Obstet. 2014; 127: 206-210
        • Cauldwell M
        • Chandraharan E
        • Pinas Carillo A
        • et al.
        Successful pregnancy outcome in woman with history of triple-P procedure for placenta percreta.
        Ultrasound Obstet Gynecol. 2018; 51: 696-697
        • Papillon-Smith J
        • Sobel ML
        • Niles KM
        • et al.
        Surgical management algorithm for caesarean scar pregnancy.
        J Obstet Gynaecol Can. 2017; 39: 619-626
        • Hunt SP
        • Talmor A
        • Vollenhoven B
        Management of non-tubal ectopic pregnancies at a large tertiary hospital.
        Reprod Biomed Online. 2016; 33: 79-84
        • Cali G
        • Timor-Tritsch IE
        • Palacios-Jaraquemada J
        • et al.
        Outcome of Cesarean scar pregnancy managed expectantly: systematic review and meta-analysis.
        Ultrasound Obstet Gynecol. 2018; 51: 169-175
        • Panaiotova J
        • Tokunaka M
        • Krajewska K
        • Zosmer N
        • Nicolaides KH
        Screening for morbidly adherent placenta in early pregnancy.
        Ultrasound Obstet Gynecol. 2019; 53 (Epub 2018 Sep 10): 101-106