35. PLACENTA PERCRETA – A CASE SERIES. (February 2015)

• Record Type: Journal Article
• Authors: Low, Julia; Camaris, Catherine; Loo, Christine
• Is Part Of: Pathology. Volume 47(2015)Supplement 1
• Publication Date: 2015-02
• Subjects: Pathology -- Periodicals; 616.0705
• DOI: 10.1097/01.PAT.0000461644.50782.e7
• Languages: English
• ISSNs: 0031-3025

Abstract

Abstract : Placenta creta (including placenta accreta, increta and percreta) is an uncommon indication for emergency caesarean section requiring emergency hysterectomy. It is defined as abnormally adherent placenta to the uterine wall, and occurs in approximately 1 in 2500 pregnancies. Risk factors include previous caesarean delivery, advanced maternal age, high gravidity, multiparity, previous curettage and placenta previa. The underlying pathophysiology is thought to be due to abnormal or absent decidualization of endometrium. There are also theories that excessive trophoblast invasion contributes to more morbid invasive placenta creatas (ie, placenta increta and percreta). This is postulated to be due to dehiscence of uterine scars or splaying of thin myometrium, rather than true trophoblastic invasion. We present a case series of eight women who were diagnosed with placenta percreta, over the last 10 years, at the Royal Hospital for Women, a tertiary obstetric referral centre in Sydney, Australia. We compare risk factors and clinical outcome, as well as histological diagnosis in relation to the pathophysiological theories of placenta creta.