Placenta accreta

Jump to navigation Jump to search

Template:DiseaseDisorder infobox

WikiDoc Resources for Placenta accreta

Articles

Most recent articles on Placenta accreta

Most cited articles on Placenta accreta

Review articles on Placenta accreta

Articles on Placenta accreta in N Eng J Med, Lancet, BMJ

Media

Powerpoint slides on Placenta accreta

Images of Placenta accreta

Photos of Placenta accreta

Podcasts & MP3s on Placenta accreta

Videos on Placenta accreta

Evidence Based Medicine

Cochrane Collaboration on Placenta accreta

Bandolier on Placenta accreta

TRIP on Placenta accreta

Clinical Trials

Ongoing Trials on Placenta accreta at Clinical Trials.gov

Trial results on Placenta accreta

Clinical Trials on Placenta accreta at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Placenta accreta

NICE Guidance on Placenta accreta

NHS PRODIGY Guidance

FDA on Placenta accreta

CDC on Placenta accreta

Books

Books on Placenta accreta

News

Placenta accreta in the news

Be alerted to news on Placenta accreta

News trends on Placenta accreta

Commentary

Blogs on Placenta accreta

Definitions

Definitions of Placenta accreta

Patient Resources / Community

Patient resources on Placenta accreta

Discussion groups on Placenta accreta

Patient Handouts on Placenta accreta

Directions to Hospitals Treating Placenta accreta

Risk calculators and risk factors for Placenta accreta

Healthcare Provider Resources

Symptoms of Placenta accreta

Causes & Risk Factors for Placenta accreta

Diagnostic studies for Placenta accreta

Treatment of Placenta accreta

Continuing Medical Education (CME)

CME Programs on Placenta accreta

International

Placenta accreta en Espanol

Placenta accreta en Francais

Business

Placenta accreta in the Marketplace

Patents on Placenta accreta

Experimental / Informatics

List of terms related to Placenta accreta

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Placenta accreta is a severe obstetric complication involving an abnormal superficial attachment of the placenta to the myometrium (the middle layer of the uterine wall). There are three forms of placenta accreta, distinguishable by the depth of penetration.

The placenta usually detaches from the uterine wall relatively easily, but women that encounter placenta accreta during childbirth are at great risk of obstetrical hemorrhage during its removal. This commonly requires surgery to stem the bleeding and fully remove the placenta, and in severe forms can often lead to a hysterectomy or be fatal.

Placenta accreta affects approximately 1 in 2,500 pregnancies.

Classification

The most common form of placenta accreta is an invasion of the myometrium which does not penetrate the entire thickness of the muscle. This form of the condition accounts for around 75-78% of all cases, and has no name other than placenta accreta.

There are two further variants of the condition that are known by specific names and are defined by the depth of their attachment to uterine wall. Placenta increta occurs when the placenta further extends into the myometrium and happens in around 17% of all cases. Placenta percreta, the worst form of the condition and occurring in 5-7% of cases, is when the placenta penetrates the entire myometrium to the uterine serosa (invades through entire uterine wall). This variant can lead to the placenta attaching to other organs such as the rectum or bladder[1].

Risk factors

The condition affects around 10% of cases of placenta praevia, and is increased in incidence by the presence of scar tissue from a past caesarean section. A thin decidua can also be a contributing factor to such trophoblastic invasion. Some studies suggest that the rate of incidence is higher when the fetus is female.[2]

Diagnosis

Placenta accreta is very rarely recognized before birth, and is very difficult to diagnose. While it can lead to some vaginal bleeding during the third trimester, this is more commonly associated with the factors leading to the condition. In some cases, the second trimester can see elevated maternal serum alpha-fetoprotein levels, though this is also an indicator of many other conditions.[3]

References

  1. Miller, David A. (2 November 2004). 'Accreta Obstetric Hemorrhage' High Risk Pregnancy Directory at ObFocus. Accessed 25 January 2006
  2. American Pregnancy Association (January 2004) 'Placenta Accreta'. Accessed 16 October 2006
  3. Mayes, M., Sweet, B. R. & Tiran, D. (1997). Mayes' Midwifery - A Textbook for Midwives 12th Edition, pp. 524, 709. Baillière Tindall. ISBN 0-7020-1757-4

Template:WH Template:WS