Placenta Accreta

Placenta accreta   {HYPERLINK  \l "top"}

Sometimes no normal decidual plate forms in pregnancy, and placental villi invade directly into myometrium, as seen here. This condition in known as placenta accreta. A hysterectomy may be necessary to control bleeding.

Diagram Slide:   http://medlib.med.utah.edu/WebPath/FEMHTML/PLAC070.html

OTHER:   GREEN METALLIC PLACENTA:  (SEE MECONIUM ASPIRATION SYNDROME (MAS)

http://medlib.med.utah.edu/WebPath/PLACHTML/PLAC015.htmlm

Full Intormation at:   http://www.pathologyoutlines.com/placenta.html

Placenta adherent to uterus

Rarely diagnosed in delivered placenta; usually only when uterus is removed

Causes postpartum bleeding and fever, although microscopic findings can also occur without symptoms

Often no obvious findings in women with vaginal deliveries after prior cesarean section

Accreta often used as a general term since the degree of invasiveness is not uniform

Accreta:  partial or complete absence of decidua with adherence of placenta directly to myometrium

Increta: villi invade myometrium

Percetra:  villous infiltration extends through full thickness of myometrium; may cause uterine rupture

Risk factors:  60% of cases are associated with placenta previa (placenta implants in lower uterine segment or

cervix, often with serious antepartum bleeding and premature labor); also more common in cesarean section scars, multigravidas and ‘elderly’ reproductive women; associated with retained placenta, postpartum hemorrhage

Due to deficiency in decidua OR abnormal invasiveness

Case report, {HYPERLINK "http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12503589&dopt=Abstract"} Archives 2002;126:1557

{HYPERLINK "http://medlib.med.utah.edu/WebPath/PLACHTML/PLAC102.html"} Diagram

Gross: ragged tissue or incomplete cotyledons on maternal floor; superficial acute hemorrhage near insertion of cord (due to excessive traction on cord during labor)

Gross images: {HYPERLINK "http://arpa.allenpress.com/arpaonline/?request=display-figures&name=i1543-2165-126-12-1557-f01"} figure 1 , {HYPERLINK "http://radiology.uchc.edu/Code/1182.HTM"} image2 , {HYPERLINK "http://medlib.med.utah.edu/WebPath/PLACHTML/PLAC040.html"} image3

Micro:  chorionic villi in direct contact with myometrial smooth muscle fibers, absence / reduction of decidua basalis layer, layer of fibrin, hemosiderin laden macrophages

Micro images: {HYPERLINK "http://medlib.med.utah.edu/WebPath/FEMHTML/PLAC070.html"} image1 ,  {HYPERLINK "http://arpa.allenpress.com/arpaonline/?request=display-figures&name=i1543-2165-126-12-1557-f01"} figures 2 (H&E), figure 3 (actin)

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A Petition to Protect Babies and Mothers, Too can be found at:

www.thepetitionsite.com/takeaction/102580814

a medical web site is available at:   www.cordclamping.com

The Merck Manual, a more current edition is available on the Internet. Try any topic:

http://www.merck.com/mrkshared/searchresults.jsp

Please feel free to scroll down the Table of Contents at the home page:   www.lotusbirth.com

References of some of research can be found at:

www.lotusbirth.com/doc/FEB2003Lotusbirth-110.htm

Contact, Donna, a Mother and Grandmother, at:   dyoung@pris.ca

Originally Posted: April 4, 2004