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Pregnancy 2023

Placenta acreta: what é, symptoms, diagnosis and risks

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Placenta acreta: what é, symptoms, diagnosis and risks
Placenta acreta: what é, symptoms, diagnosis and risks

Placenta accreta, also known as placental accreta, is a situation in which the placenta is not properly adhered to the uterus, making it difficult for it to come out at the time of delivery. This situation is one of the main causes of complications and postpartum death, as it is associated with a great risk of bleeding.

Placental accreta can be classified according to the depth of implantation of the placenta to the uterus in:

  • Placenta accreta simple, in which the placenta invades part of the myometrium, which is the middle layer of the uterus;
  • Placenta increta, in which the placenta fully penetrates the myometrium;
  • Placenta percreta, in which the placenta may reach only the serosa or adjacent organs.

It is important that placenta accreta is diagnosed during prenatal examinations so that cesarean section followed by hysterectomy can be scheduled, which is normally the indicated treatment, and thus, complications for the mother and for the baby are prevented. baby.

Symptoms of Placenta Acreta

Normally the woman does not feel any symptoms of placental alteration, therefore, it is important that the woman performs prenatal care correctly so that this alteration can be identified.

Although signs and symptoms are not frequent in these cases, some women may experience discreet vaginal bleeding, without pain and for no apparent reason during pregnancy, and it is recommended that you go to the gynecologist/obstetrician to identify the cause of the bleeding and start treatment.

How the diagnosis is made

The diagnosis of placenta accreta must be made through imaging tests, such as ultrasound and magnetic resonance imaging, in addition to the measurement of blood markers that may indicate the change.These tests can be performed prenatally and the early diagnosis of placental accreta reduces the risk of complications for the woman. Find out about other tests performed during prenatal care.

Ultrasonography is usually indicated for patients considered to be at high risk and is a very safe technique for both mother and baby. The use of magnetic resonance imaging for the diagnosis of placenta accreta is controversial, however it may be indicated when the ultrasound result is considered doubtful or inconclusive.

Ultrasonography to identify placenta accreta is more indicated in women who are at greater risk of developing this problem, such as older women who have previously undergone uterine surgery, including cesarean section, have fibroids uterine or who have had placenta previa, in which the placenta develops partially or completely in the lower region of the uterus. Learn more about placenta previa and how to treat it.

Possible risks

The risks of placenta accreta are related to when the placenta accreta is identified. The earlier the diagnosis is made, the lower the risk of postpartum hemorrhage, complications during delivery, premature delivery and the need for an emergency cesarean section.

In addition, there can be infection, problems related to clotting, bladder rupture, loss of fertility and, if not identified and treated correctly, can lead to death.

Treatment for Placenta Acreta

Treatment of placental accreta may vary from woman to woman, and cesarean section can be performed together with hysterectomy, which is the medical procedure in which the uterus is removed and, depending on the severity, associated structures, such as fallopian tubes and ovaries.

In some cases, conservative treatment may be indicated to preserve the woman's fertility, with only cesarean section and placenta removal being performed, in addition to monitoring the woman after delivery to monitor possible bleeding or complications.

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