Post Partum Hemorrage Flashcards
Placenta accreta
Placenta accreta occurs when the placenta is directly adherent to the myometrium instead of the decidua basalis but does not invade or penetrate the myometrium (i.e., placenta increta). Although the exact etiology is unknown, previous C-sections are the most important risk factor. Clinically, patients present with delayed placental detachment and massive, life-threatening postpartum hemorrhage at the time of attempted manual separation of the placenta, as seen in this patient. During the prenatal period, patients are often asymptomatic and diagnosis is generally made via routine prenatal ultrasound. In the rare event that a placenta accreta is first diagnosed after vaginal delivery, as in this patient, emergent laparotomy is indicated to control the bleeding.
