Placenta Accreta A Report of Six Cases

Abstract

Summary Placenta accreta is a very rare condition, although minor degrees probably occur more frequently than can be recognized. The abnormal relationship between the chorionic tissue and the decidua may involve part or all of the placental surface. The depth of involvement also varies … the chorionic villi may abut directly on to the surface of the myometrium, or pass into its substance, or progress through it to the serous surface of the uterus. Six cases are described and are compared with 34 cases collected from the recent literature. Placenta accreta may be suspected if there is a history of manual removal or curettage after delivery, or if the existing pregnancy is complicated by placenta praevia. The complications of placenta accreta are considered, and it is emphasized that methods of management which are usually adequate may not suffice when this condition is present. Occasionally hysterectomy may be necessary, and if so the subtotal operation with preservation of the ovaries is the procedure of choice. It is important to conduct obstetrics in hospitals with readily available facilities for blood transfusion, and for surgical treatment if necessary, if maternal death due to this abnormality is to be prevented.