Abnormally Adhered Placenta

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  1. Define the three types of abnormally adhered placentas
    • Accreta - attached to myometrium
    • Increta - infiltrates myometrium
    • Percreta - thru myometrium & into adjacent tissues

    Placenta implants in an area of low decidual formation (i.e. lower uterine segment, scar)
  2. Risk factors for abnormally adhering placenta
    • Hx CS
    • Hx CS & previa this pregnancy
    • Gravida >6
    • >35yrs
    • MSAFP > 2.5
    • free βhCG >2.5
  3. Management of abnormally adhered placenta
    *Pre-birth identification via US

    • Usually CS, hyster w/ placenta in place PRN
    • Consider transfer to Level III facility w/ surgical and blood bank capabilities
    • Get OB, ONC, Urology on board

    Removal of placenta with packing NOT RECOMMENDED d/t high maternal mortality
Card Set
Abnormally Adhered Placenta
Abnormally adhered placenta NM 622
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