Placenta Accreta, grades, Signs & Symptoms, Risk factors, Diagnosis. Complication, Treatment.

1. 1
Placenta Accreta
The placenta grows in your uterus, and supplies the baby
with food and oxygen through the umbilical cord.
Normally, the placenta grows onto the upper part of the
uterus and stays there until your baby is born.
During the last stage (third stage) of labor, the placenta
separates from the wall of the uterus, and your contractions
help push it into the vagina (birth canal).
• Typically, Body expels the placenta within 30 minutes
of delivery.
• However, if the placenta or parts of the placenta
remain in your uterus for more than 30 minutes after
childbirth, it’s considered a placenta accreta “retained”.
• - Sometimes the placenta attaches itself into the wall
of the uterus too deeply. This can cause problems,
including: Placenta Accreta, Increta, and Percreta.
Three grades of abnormal placental attachment are defined
according to the depth of invasion:
1. Placenta accreta – The placenta attaches itself too
deeply and too firmly into the uterus.
accounting for 75 % of all cases.
2. Placenta increta – The placenta attaches itself even
more deeply into the muscle wall of uterus.
accounting for 15 % of all cases.

2. 2
3. Placenta percreta – The placenta attaches itself and
grows through the uterus, sometimes extending to nearby
organs, such as the bladder.
accounting for 10 % of all cases.

3. 3
Placenta accreta occurs when all or part of
the placenta attaches abnormally to the myometrium.
- Because of abnormal attachment to the myometrium,
placenta accreta is associated with an increased risk of
heavy bleeding at the time of placental delivery.
- The need for transfusion of blood products is frequent,
and hysterectomy is sometimes required to control
life-threatening hemorrhage.
Signs & Symptoms:
- Often causes no signs or symptoms during pregnancy.
- vaginal bleeding during the third trimester is possible.
Risk factors
 The mother’s age:
(placenta accreta is more common in women over
the age of 35)
 placenta previa, If placenta partially or totally covers
the cervix - or sits in the lower portion of your uterus.
 Abnormal conditions in the uterus; such as uterine
fibroids, or scar tissue.
 Previous uterine surgery.
 Previous pregnancies
 Mother carrying twins or multiples

4. 4
Diagnosis:
 ultrasound
 MRI
Complication:
1. severe vaginal bleeding (hemorrhage) can occur during
manual attempts to detach the placenta.
2. damage to local organs (e.g., bowel, bladder, ureters).
3. premature delivery
Treatment:
 Hysterectomy (the most common intervention)
Most healthcare professionals will monitor the
expectant mother very closely for the remainder of
her pregnancy to ensure that no further
complications arise.