A 30-year-old G2P1 is undergoing an elective repeat caesarean section at term. The infant is delivered without any dificulties, but the placenta cannot be removed easily because a clear plane between the placenta and uterine wall cannot be identified. The placenta is removed in pieces. This is followed by uterine atony and haemorrhage. All of the following are true regarding the condition except
With placenta accreta a cesarean hysterectomy may be required. This is because there is uncontrollable bleeding often when placental delivery is attempted. Hysterectomy is frequently required since regular methods of reducing bleeding with suturing mostly don't work. Nitabuch's layer limits invasion of the decidua by the trophoblast. The membrane is absent in the placenta accreta. It causes morbid adhered placenta Placenta accreta:- Paial or complete absence of decidua with adherence of placenta directly to the superficial myometrium Placenta increta :- Villi invade into but not through the myometrium Placenta percreta :- Villi invade through the full thickness of myometrium to the serosa
Previous LSCS is a predisposing factor
Absence of Nitabuch's membrane
May require obstetric hysterectomy
If Placenta invades muscle and reaches serosa it is known as placenta increta
Obstetrics