Clinical Pearls

The usual management of placenta accreta (abnormal adherence of the placenta to the uterus) is hysterectomy.

Placenta accreta is associated with a defect in the decidua basalis.

The risk of placenta accreta increases in a woman with a prior uterine incision and placenta previa. The greater the number of cesarean deliveries, the higher the risk of accreta.

Low-lying or marginal placenta previa diagnosed in the second trimester often will resolve later in pregnancy, so repeat sonography is prudent.

REFERENCES

Cunningham FG. Leveno KJ, Bloom SL. Hauth JC, Gilstrap LC III. Wenstrom KD. Obstetrical hemorrhage. In: Williams obstetrics, 22nd ed. New York: McGraw-Hill, 2005:830-832.

Hayashi RH. Gambone JC. Obstetrical hemorrhage and puerperal sepsis. In: Hacker NF. Moore JG, Gambone JC, eds. Essentials of obstetrics and gynecology, 4th ed. Philadelphia: Saunders. 2004:146-156.

American College of Obstetricians and Gynecologists. Placenta accreta. ACOG Committee Opinion 266. Washington, DC: American College of Obstetricians and Gynecologists. 2002.

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