Placenta accreta: review and 3 case reports

Abstract

Placenta accreta is characterized by excessive penetration of the villi into the myometrium, which obstructs its correct separation during stage III of labor. That in turn leads to a potentially life-threatening maternal hemorrhage. Until recently, this pathology has been a rare occurrence but currently it is fifty times more prevalent. Placenta accreta is associated with high morbidity and the risk of maternal death, even despite advances in ultrasonographic diagnostics, well-established surgical treatment, and multi-disciplinary medical care. A dramatic rise in the rates of Cesarean section and intrauterine surgical procedure is considered to be the main factor responsible for the growing incidence of placenta accreta. It is especially frequent in women after a Cesarean section and with placenta previa covering the lower segment. A Cesarean section, combined with hysterectomy and application of various techniques to limit massive bleeding, is usually performed between 34-36 weeks of pregnancy, before the onset of labor. Three cases of placenta accreta are presented.