PLACENTA ACRETEA

by **zamasy20** on Thu 03 Jul 2008, 8:27 pm

Placenta accreta- abnormal placental implantation when the anchoring placental villi attach to the myometrium instead of being contained by decidual.
Placenta increta- chorionic villi invade into the myometrium.
Placental percreta- chorionic villi penetrate to or through the uterine serosa and may invade surrounding organs.

Incidence- increased from before, 1/533 deliveries.Higher risk if have prior c-sections.Accreta occurs in 15-20% of women with previa and one prior section.

Outcome risks - postpartum hemorrhage and subsequent hysterectomy.

1. U/S has 85% sensitivity and specificity for detecting placenta accreta.

2. Color Doppler shows placental lacunar flow, hypervascularity of the bladder uterine serosa, prominent subplacental venous complex, and loss of subplacental Doppler vascular signals.

3. MRI- when the diagnosis is uncertain, the placenta is posterior or to better see depth of invasion. Can lead to modifications in clinical management such as prophylactic ureteral catheterization.