placenta accretta

Question 1

placenta accreta

Answer 1

refers to when the placenta implants deeper, through and past the endometrium making it difficult to separate the placenta after delivery

Question 2

accreta vs increta vs percreta

Answer 2

accreta : placenta implants in the surface of the myometrium
increta : deep into the myometrium
percreta : past myometrium and perimetrium reaching other organs like the bladder

Question 3

risk factors

Answer 3

Previous placenta accreta
Previous endometrial curettage procedures (e.g. for miscarriage or abortion)
Previous caesarean section
Multigravida
Increased maternal age
Low-lying placenta or placenta praevia

Question 4

presentation

Answer 4

generally asymptomatic
antepartum haemorrhage in 3rd trimester
diagnosed at birth due to difficulty delivering placenta

Question 5

diagnosis and management

Answer 5

antenatal by ultrasound

planned delivery between 35 to 36+6 weeks + antenatal steroids with either hysterectomy, resection preserving surgery or expectant management

Question 6

complication of placenta accreta

Answer 6

PPH