O43.2

Clinical Causes: Previous cesarean section or other uterine surgeries, which can cause scarring of the uterine lining Placenta previa, where the placenta covers the opening of the cervix Advanced maternal age, typically over 35 years Multiple pregnancies or previous history of placenta accreta Uterine abnormalities or anomalies

Key Symptoms: Unusual bleeding during pregnancy, especially in the third trimester Heavy vaginal bleeding at delivery Difficulty in detaching the placenta after childbirth Signs of postpartum hemorrhage, including excessive bleeding and low blood pressure Potential signs of uterine rupture in severe cases

Diagnosis Path: Diagnosis often involves imaging studies to assess placental attachment. Common methods include: - **Ultrasound**: The primary tool for diagnosing placenta accreta spectrum disorders, revealing abnormal placental invasion or thinning of the myometrium. - **Magnetic Resonance Imaging (MRI)**: Used in complex cases or when ultrasound results are inconclusive, providing detailed images of placental placement and extent of invasion. In some instances, diagnosis is confirmed during delivery or through pathological examination of the placenta after delivery.

Treatment Protocols: Management of morbidly adherent placenta depends on the severity of placental invasion, gestational age, and maternal health. Approaches include: - **Planned Cesarean Hysterectomy**: Often for severe cases, where the uterus is removed to prevent hemorrhage. - **Conservative Management**: In selected cases, attempts may be made to remove the placenta and preserve the uterus, but this carries significant risk. - **Preoperative Planning**: Involving a multidisciplinary team, including obstetricians, anesthesiologists, and surgeons, to prepare for potential complications. - **Blood Product Availability**: Ensuring availability of blood transfusions to manage blood loss. - **Postoperative Care**: Monitoring for bleeding, signs of infection, and other complications. Early diagnosis and appropriate planning are crucial to minimize risks associated with this condition.