Placental implantation

Question 1

Give risk factors for abnormal placental implantation

Answer 1

Previous C-section
Placenta praevia
Previous abnormal invasive placentation

Question 2

What is the pathophysiology of placenta accreta?

Answer 2

deficiency in the decidua basalis

Question 3

Define placenta accreta

Answer 3

chorionic villi ATTACH to the MYOMETRIUM
rather than being confined by the decidua basalis

Question 4

Define placenta increta

Answer 4

chorionic villi INVADE into the MYOMETRIUM

Question 5

Define placenta percreta

Answer 5

chorionic villi fully PENETRATE MYOMETRIUM + extend THROUGH into the uterine serosa (PERIMETRIUM).
In some cases they can invade into surrounding structures.

Question 6

Give 4 complications of abnormal invasive placentation

Answer 6

Preterm delivery
APH
Risk of severe haemorrhage
Death (P. percreta 7%)

Question 7

Why is there a risk of severe post partum haemorrhage with abnormal invasive placentation?

Answer 7

placenta does not properly separate during labour