Reply to: Modified cesarean hysterectomy technique for management of cases of placenta increta and percreta at a tertiary referral hospital in Egypt
I want to congratulate Hussein et al.  for their extensive work. I am aware of the catastrophic figures of percreta due to the epidemics of cesarean section in their country. In fact, Egypt is the third country on the row considering the rate of cesarean section. The total Egyptian population is more than 100 million and the natality is approximately 4 per woman.
Lebanon is a smaller country with a similarly high rate of cesarean section. We organized the management of this disease by creating a network collaboration between three university hospitals that receive all cases from the whole country.
In my department, I extrapolated gynecologic oncology techniques to apply them in the management of percreta cases. In fact, as I have stated in my first letter in 2013, the disease is different from one patient to another and the management differs from a patient to another, opening the door for conservation . The problem is percreta, when we have an anterior bladder...
DA: conceptualization, writing original draft, reviewing and editing. MM: writing original draft, reviewing and editing. NE: writing original draft, reviewing and editing.
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Conflict of interest
All the authors declare that they have no conflict of interest.
- 7.Atallah D, Moubarak M, Saliba S, Nassar M, Abboud S, Kesrouani A, Ghossain M, Elkassis N (2018) Placental malformation: accreta and beyond. In: Ahmed RG (ed) Placenta. IntechOpen, London, pp 73–84Google Scholar