Maternal Morbidity Associated With Multiple Repeat Cesarean Deliveries

The article provides a review of a landmark study characterizing the risk of repeat cesarean deliveries. This multicenter prospective cohort study of over 30,000 cesarean deliveries demonstrates that risks of cesarean delivery increase sequentially, even in the absence of placenta accreta. The most dramatic increase is noted in the high rates of accreta with placenta previa and multiple cesarean deliveries, greater than 40% with 3 of more cesarean deliveries. This review highlights the key findings, methodology, and impact of this landmark study. It discusses other studies that continue to verify these results as well as contextualize them in the management of placenta accreta with developing centers of excellence. Finally, the article provides a sample clinical case scenario that applies the findings of this study.