Prior cesarean section and placenta accreta spectrum disorders: some clarifications
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We would like to thank Professor Shigeki Matsubara for his valuable clarifications and his artistic illustrations. Please see our reply below.
First, whether their “PAS-associated morbidities” actually reflected “PAS related” were not identified. Zeevi et al. state that “the risk for maternal complications (postpartum hemorrhage, hysterectomy, and uterine surgeries) associated with placenta accreta was more pronounced among women who had an unplanned CS”. We wonder how Zeevi et al. identified that these three conditions were “PAS-related”. Although PAS may cause these three conditions, whether it was due to PAS in this study was not identified. Some cohort studies demonstrated an increased risk of extensions of the uterine incision and postpartum hemorrhage in second-stage CS [4, 5]. Such uterine damage may affect the next pregnancy. In fact, the incidence of preterm delivery increased in women with a previous history of second-stage CS, possibly due to cervico-isthmic...
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Conflict of interest
The authors declare that they have no conflicts of interest.