Further prospective studies including other so-nographic markers of massive hemorrhage or adher-ence of placenta such as extensive vascular lakes [18], heterogeneity of placenta, loss of myometrial zone [19], sponge-like cervix and marginal sinus [9] could be required and it will give us more information about the relationship of anterior placenta with ac-creta or massive bleeding and finally it enables more tailored management.