Placenta accreta

Background

  • 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

Differential Diagnosis

Abdominal Pain in Pregnancy

The same abdominal pathologies as non-pregnant patients, plus:

<20 Weeks

>20 Weeks

Any time

  • Hemorrhagic ovarian cyst
  • Fibroid degeneration or torsion
  • Ovarian torsion
  • Constipation

Evaluation

Management

Disposition

See Also

References