Scribd
Upload
182 views4 pages

Placenta Accreta: What Is The Difference Between Accreta, Increta or Percreta?

Placenta accreta is an abnormal attachment of the placenta to the uterine wall that occurs when the lining between the placenta and uterus is damaged or absent. It is a risk for women who have had prior uterine surgeries or placenta previa. Placenta accreta risks severe bleeding during delivery if the placenta does not separate properly from the uterus. Depending on the severity, it may require a hysterectomy to control life-threatening bleeding. Factors like cesarean sections and advanced maternal age increase the risk of developing placenta accreta.

Uploaded by

Bryan Neil Garma
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
182 views4 pages

Placenta Accreta: What Is The Difference Between Accreta, Increta or Percreta?

Placenta accreta is an abnormal attachment of the placenta to the uterine wall that occurs when the lining between the placenta and uterus is damaged or absent. It is a risk for women who have had prior uterine surgeries or placenta previa. Placenta accreta risks severe bleeding during delivery if the placenta does not separate properly from the uterus. Depending on the severity, it may require a hysterectomy to control life-threatening bleeding. Factors like cesarean sections and advanced maternal age increase the risk of developing placenta accreta.

Uploaded by

Bryan Neil Garma
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
You are on page 1/ 4

Placenta Accreta

The placenta normally attaches to the uterine wall, however there is a condition that occurs where the
placenta attaches itself too deeply into the wall of the uterus. This condition is known as placenta accreta,
placenta increta, or placenta percreta depending on the severity and deepness of the placenta attachment.
Approximately 1 in 2,500 pregnancies experience placenta accreta, increta or percreta.

What is the difference between accreta, increta or percreta?


The difference between placenta accreta, increta or percreta is determined by the severity of the
attachment of the placenta to the uterine wall.

Placenta Accreta occurs when the placenta attaches too deep in the uterine wall but it does not penetrate
the uterine muscle. Placenta accreta is the most common accounting for approximately 75% of all cases.

Placenta Increta occurs when the placenta attaches even deeper into the uterine wall and does penetrate
into the uterine muscle. Placenta increta accounts for approximately 15% of all cases.

Placenta Percreta occurs when the placenta penetrates through the entire uterine wall and attaches to
another organ such as the bladder. Placenta percreta is the least common of the three conditions
accounting for approximately 5% of all cases.

What causes placenta accreta?


The specific cause of placenta accreta is unknown, but it can be related toplacenta previa and
previous cesarean deliveries. Placenta accreta is present in 5% to 10% of women with placenta previa.
A cesarean delivery increases the possibility of a future placenta accreta, and the more cesareans, the
greater the increase. Multiple cesareans were present in over 60% of placenta accreta cases.

What are the risks of placenta accreta to the baby?


Premature delivery and subsequent complications are the primary concerns for the baby. Bleeding during
the third trimester may be a warning sign that placenta accreta exists, and when placenta accreta occurs it
commonly results in a premature delivery. Your healthcare provider will examine your condition and use
medication, bed rest and whatever else necessary to help continue the pregnancy towards full term.

What are the risks of placenta accreta to the mother?


The placenta usually has difficulty separating from the uterine wall. The primary concern for the mother is
hemorrhaging during manual attempts to detach the placenta. Severe hemorrhaging can be life
threatening. Other concerns involve damage to the uterus or other organs (percreta) during removal of the
placenta. Hysterectomy is a common therapeutic intervention, but the results involve the loss of the uterus
and the ability to conceive.

What is the treatment for placenta accreta?


There is nothing a woman can do to prevent placenta accreta, and there is little that can be done for
treatment once placenta accreta has been diagnosed. If you have been diagnosed with placenta accreta
your healthcare provider will monitor your pregnancy with the intent of scheduling a delivery and using a
surgery that may spare the uterus. It is particularly important to discuss this surgery with your doctor if
you desire to have additional children.
Unfortunately, placenta accreta may be severe enough that a hysterectomy may be needed. Again, it is
important to discuss surgical options with your healthcare provider.

Etiology
 Predisposing factors are prior uterine surgery and placenta previa.

Pathophysiology
 Implantation in an area of defective endometrium with no zone separation between the placenta and the
myometrium.

Assessment Findings
1.Associated findings. Placenta accrete is usually diagnosed in the immediate postpartum period when the
placenta fails to separate.
2. Clinical manifestations
a. Placenta fails to separate
b. profuse hemorrhage may result depending on the portion of placenta involved.

Nursing Management
1.Identify placenta accrete in the client. Be aware of the client’s risk status.
2. Assist with rapid treatment and intervention. Be prepared for a dilation and curettage or hysterectomy.
3. Provide physical and emotional support.
4. Provide client and family education.
Placenta accreta
Defiition
Placenta accreta is an abnormal attachment of part or all of the placenta to the uterine wall. It is caused by
the partial or complete absence of the thin lining (decidua basalis) that separates the placenta from the
uterine muscle (myometrium).

If this lining is missing or damaged, the chorionic villi of the placenta attaches directly onto the uterine
muscle. This causes a serious problem at the time the placenta is delivered. Because of its firm
attachment, the placenta may not separate from the uterus, causing significant bleeding.

Placenta accreta is positively associated with a high number of births, placenta previa,
prior cesarean section, and prior uterine surgery.

Risk: Risk factors for placenta accreta include a maternal age greater than 35 years (Hung).

Diagnosis

History: Typically, placenta accreta remains asymptomatic until delivery, when incomplete separation of the placenta
occurs. Massive bleeding (hemorrhage) is the most significant sign of placenta accreta.

Physical exam: Placental fragments may be felt inside the uterus. Inspection of the placenta already removed
reveals damaged or missing portions.

Tests: Women at risk for placenta accreta should be screened by ultrasound examination or the ultrasonic technique
for detecting anatomic details called color-flow Doppler studies. MRI is not used to establish a diagnosis of placenta
accreta but can be used to confirm or rule out the condition when ultrasound results are uncertain.

Treatment

Managing placenta accreta requires controlling hemorrhaging; removing the placenta that has adhered to
the uterine wall is very difficult and can result in blood loss. If the diagnosis is made before labor begins,
a cesarean section should be performed whenever possible and blood products should be readily
available. In cases of severe bleeding, control of bleeding while avoiding a hysterectomy is done by
selectively occluding (embolizing) pelvic vessels with embolizing agents such as vasoconstrictors,
absorbable gelatin sponge, microfibrillar collagen, polyvinyl alcohol, or silicone beads and by performing
balloon occlusion of the aorta or lower abdominal region (hypogastric) vessels. In the majority of cases, a
hysterectomy remains the treatment of choice.

Regular prenatal visits to a physician or maternity clinic are essential for a healthy, safe pregnancy,
delivery and postpartum period.

Prognosis
There is little that can be done once a woman has been diagnosed with placenta accreta. If severe
enough, a hysterectomy may be indicated.
Complications

Complications include massive bleeding (postpartum hemorrhage), perforation of the uterus, uterine


prolapse, infection, and death.

Restrictions

Following cesarean section and/or hysterectomy, particularly an abdominal hysterectomy, heavy lifting,
excessive standing, climbing, bending, kneeling, stooping, and squatting may need to be restricted.

You might also like

pFad - Phonifier reborn

Pfad - The Proxy pFad of © 2024 Garber Painting. All rights reserved.

Note: This service is not intended for secure transactions such as banking, social media, email, or purchasing. Use at your own risk. We assume no liability whatsoever for broken pages.


Alternative Proxies:

Alternative Proxy

pFad Proxy

pFad v3 Proxy

pFad v4 Proxy