Placenta accreta Flashcards
What is the placenta accreta spectrum?
Where the placenta implants into and past the endometrium, making it difficult to separate the placenta after delivery of the baby
What is placenta accreta?
Where the placenta implants into the surface of the endometrium
What is placenta increta?
Where the placenta implants deeply into the myometrium
What is placenta percreta?
Where the placenta implants past the myometrium and perimetrium, and can reach organs such as the bladder
What are the risk factors for placenta accreta?
Previous placenta accreta
Previous endometrial curettage procedures
Previous C section
Multigravida
Increased maternal age
Placenta praevia
Uterine structural defects
What is the endometrium?
The inner layer of the uterine wall that contains connective tissue, epithelial cells and blood vessels
What is the myometrium?
The middle layer of the uterine wall that contains smooth muscle
What is the perimetrium?
The outer layer of the uterine wall, which is a serous membrane similar to the peritoneum
How is placenta accreta diagnosed?
Antenatal ultrasound
MRI scan to assess depth and width of invasion
When is delivery planned for women with placenta accreta?
Between 35 and 36+6 gestation
What are the management options for placenta accreta during C section delivery?
Hysterectomy
Uterus preserving surgery
- Resection of part of the myometrium alongside the placenta
Expectant management
- Leaving the placenta to be absorbed over time
