Cesarean section per se is not a risk factor for non‐anatomical placenta creta

Abstract

Retained placentas complicate approximately 3% of all deliveries, 1 with only a proportion of them featuring lesions of histological placenta creta (PC) spectrum, i.e. accreta, increta, and percreta.Placenta accreta was first reported in 1927, with the term PC later introduced. Prenatal ultrasonography for PC diagnosis was used as the primary method for diagnosing morbidly adherent placenta, 2 sometimes supplemented by magnetic resonance imaging. 3 More than 90% of PCs now occur in women with a history of cesarean deliveries or placenta previa; other risk factors include other uterine surgeries, use of assisted reproduction technologies, preterm delivery, advanced maternal age in developed countries, in utero hypoxia, and maternal conditions such as gestational hypertensive disease and maternal vascular malperfusion. 4,5 Only a half of PC cases are suspected before delivery; however, outcomes of expected versus