Morbidly adherent placenta or abnormal placentation comprises placenta accreta where
placental villi adhere directly to the myometrium; placenta increta with invasion
into the myometrium; and placenta percreta with invasion through the myometrium into
the peritoneal cavity and possibly into other pelvic organs. Common to these conditions
is failure of the placenta to separate normally after birth with accompanying uterine
atony and ensuing major haemorrhage. There has been a 10-fold rise in the incidence
of morbidly adherent placenta over the last four decades. Independent risk factors
are the presence of a placenta praevia, previous caesarean section and advanced maternal
age and as such it comes as no surprise that the incidence should be rising. Morbidly
adherent placenta is associated with severe morbidity and mortality with intrapartum
and postpartum haemorrhage the most common complications
1
, responsible for 39% of peripartum hysterectomies in the UK.
2
Other complications include damage to bladder or ureters, requirement for intensive
care and ventilation and repeat laparotomy.
1
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Article info
Publication history
Published online: September 12, 2011
Accepted:
August 6,
2011
Identification
Copyright
© 2011 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
