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Doctor insights on: Placenta Accreta

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Dr. Nikolaos Zacharias
104 doctors shared insights

Placenta Accreta (Overview)

Placenta accreta is a condition where the placenta is attached too deeply to the wall of the uterus, making it more difficult to detach after birth.


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What is the best way of managing placenta accreta and percreta?

What is the best way of managing placenta accreta and percreta?

Resorption: If placenta percreta/accreta is recognized at the time of delivery and there is no bleeding then allowing the uterus to contract and retained placenta to be excreted or absorbed later on its' own volition is a wise course. However, if there is massive uncontrollable bleeding then cesarean hysterectomy is the "default" choice. Uterine balloon "packing" can be also be tried to arrest bleeding. ...Read more

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Dr. Nikolaos Zacharias
104 doctors shared insights

Placenta Accreta (Overview)

Placenta accreta is a condition where the placenta is attached too deeply to the wall of the uterus, making it more difficult to detach after birth.


2

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What are the symptoms of placenta accreta?

What are the symptoms of placenta accreta?

Only at delivery: There are no symptoms during the pregnancy. Accreta presents with a placenta that will not detach after the infant is born. If the placenta is manually removed or removed under traction there is a great deal of bleeding, which may require surgery and possibly a hysterectomy. Accretas can sometimes be diagnosed prior to delivery via ultrasound or mri. ...Read more

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What are the tests for placenta accreta?

What are the tests for placenta accreta?

Ultrasound, Doppler.: The provisional working diagnosis is achieved prenatally with history taking and a targeted ultrasound examination by an expert in the field. Mri is not generally helpful, unless the placental invasion is posteriorly. The final diagnosis is made by pathological examination of the uterus and placenta en bloc after a cesarean hysterectomy. ...Read more

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What is the cause of placenta accreta?

What is the cause of placenta accreta?

Uterine scars/defect: The placenta tends to implant over pre-existing uterine scars or defects; when that occurs, the invasive nature of the placenta can lead to abnormally increased vascularity in areas without sufficient uterine muscle to control the bleeding once the placenta is delivered (particularly near the cervix). That is potentially life-threatening if undiagnosed until delivery and managed in small hospital! ...Read more

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What is the treatment for placenta accreta?

What is the treatment for placenta accreta?

Prelabor c-hyst @34w: The optimal management of placenta previa with suspected accreta/increta/percreta is prelabor cesarean section by 34-35 weeks after Betamethasone administration without amniocentesis for fetal lung maturity; this should be immediately followed by puerperal hysterectomy with the expert help from a gynecologic oncologist, urologist, [vascular] surgeon. Do not attempt to detach the placenta! ...Read more

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What is the cause of placenta accreta?

Uterine scars/defect: The placenta tends to implant over pre-existing uterine scars or defects; when that occurs, the invasive nature of the placenta can lead to abnormally increased vascularity in areas without sufficient uterine muscle to control the bleeding once the placenta is delivered (particularly near the cervix). That is potentially life-threatening if undiagnosed until delivery and managed in small hospital! ...Read more

See 1 more doctor answer
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What are the tests for placenta accreta?

Ultrasound, Doppler.: The provisional working diagnosis is achieved prenatally with history taking and a targeted ultrasound examination by an expert in the field. Mri is not generally helpful, unless the placental invasion is posteriorly. The final diagnosis is made by pathological examination of the uterus and placenta en bloc after a cesarean hysterectomy. ...Read more

See 1 more doctor answer
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What are the symptoms of placenta accreta?

Only at delivery: There are no symptoms during the pregnancy. Accreta presents with a placenta that will not detach after the infant is born. If the placenta is manually removed or removed under traction there is a great deal of bleeding, which may require surgery and possibly a hysterectomy. Accretas can sometimes be diagnosed prior to delivery via ultrasound or mri. ...Read more

See 1 more doctor answer
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What makes it likely to have placenta accreta?

What makes it likely to have placenta accreta?

Uterine scarring: Women with a history of fibroid surgery or previous ceasarean whose placenta implants on scar tissue have a small, but present potential for the placenta to dig in too deeply. It can just happen de novo, too. ...Read more

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Placenta (Definition)

The placenta is an organ that connects the developing fetus to the uterine wall to allow nutrient uptake, waste elimination, and gas exchange via ...Read more