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Flashcards in Placenta Accreta Deck (9)
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Placenta accreta? Abnormality of what layer? Histology?

Abnormal adherence of the placenta to the uterine wall – due to an animality of the decidua basalis (placental villi are attached to the myometrium)

1

Placenta increta?

Abnormally implanted placenta penetrates into myometrium

2

Placenta percreta? Common complication?

Abnormally implanted placenta penetrates entirely through myometrium and into serosa

Invasion into bladder

3

Risk factors for placental adherence?

1. Anterior/Low lying placenta
2. Placenta previa
3. Prior C-section or uterine scar
4. Uterine curettage or Prior myomectomy
5. Fetal down syndrome

4

Differentiating complete versus incomplete placenta accreta

No bleeding versus antepartum bleeding

5

Initial management hope retained placenta? Finding of placenta accreta ? Do not try?

Manual extraction with effort to find cleavage plane between placenta uterus

No cleavage plane between placenta and uterus

D&C – can cause hemorrhage and exsanguination

6

Transmigration of the placenta?

Rapid growth of lower uterine segment (in a low lying placenta) during the third trimester

7

50% risk for placenta accreta if?

3+ prior C-sections with placenta previa

8

Treatment of placenta accreta? If Patient refuses? Side effects?

Hysterectomy

Location of umbilical cord is highest possible and IV methotrexate (hemorrhage and infection)