View source for Placenta accreta

==Background==
[[File:2910 The Placenta-02.jpg|thumb|Normal placental anatomy.]]
[[File:Placenta accreta.png|thumb|Schematic showing types of placenta accreta.]]
*Placenta accreta - superficial attachment to myometrium, uterus is possibly savable without hysterectomy
*Usually requires hysterectomy
**Placenta increta - invasion of myometrium
**Placenta percreta - penetrates myometrium, into serosa, possibly bladder
*Associated with [[Placental abruption]]

===Risk factors===
*Prior C-section
*Other uterine surgery
*Low lying placenta
*[[Placenta previa]]
*Grand multiparity
*Asherman syndrome

==Clinical Features<ref>https://www.merckmanuals.com/professional/gynecology-and-obstetrics/abnormalities-and-complications-of-labor-and-delivery/placenta-accreta</ref>==
*[[Postpartum hemorrhage]], often severe, is major risk
*Typically causes no symptoms during pregnancy
*May cause [[vaginal bleeding]] in 3rd trimester
*May cause [[preterm labor]]
*Placenta may not deliver within 30 min of delivery
**Attempts at manual separation fail due to no natural plane of separation or may cause massive bleeding

==Differential Diagnosis==
{{Abdominal Pain Pregnancy DDX}}

==Evaluation==
*[[Pelvic ultrasound]]
*CBC, T&S

==Management==
*Consult Ob/gyn, particularly if significant bleeding
*Resuscitate

==Disposition==
*Admit

==See Also==
*[[Pregnancy (main)]]

==References==
<References/>

[[Category:OBGYN]]