gynecology and obstetrics
Placenta Accreta
Introduction
Placenta accreta is an abnormally adherent placenta, resulting in delayed delivery of the placenta. Placental function is normal, but trophoblastic invasion extends beyond the normal boundary between the endometrium and myometrium (Nitabuch layer). In such cases, manual removal of the placenta, unless scrupulously done, results in massive postpartum hemorrhage. Prenatal diagnosis is by ultrasonography. Treatment is usually with cesarean hysterectomy. Inplacenta accreta,the placental villi are not contained by uterine decidual cells, as occurs normally, but attach to the myometrium. Placenta accreta spectrum includes 2 additional subtypes ( General reference ): Placenta increta:Invasion of chorionic villi into the myometrium Placenta percreta:Penetration of chorionic villi into or through the uterine serosa All three subtypes cause similar complications. 