O43.213

Clinical Causes: Previous cesarean delivery, especially multiple surgeries Abdominal surgeries or uterine surgeries such as fibroid removal Placenta previa, where the placenta covers the cervix opening Advanced maternal age Previous uterine scarring or infections Multiple gestation pregnancies

Key Symptoms: Vaginal bleeding during the third trimester Abnormal fetal heartbeat patterns Unusual uterine tenderness or pain Signs of placental detachment such as contractions or bleeding In severe cases, signs of maternal shock due to heavy bleeding

Diagnosis Path: Diagnosis of placenta accreta typically involves a combination of imaging studies and clinical examination. Ultrasound is the primary modality used, often revealing abnormal blood vessels or placental invasion into the uterine wall. In some cases, MRI may be employed to assess the extent of placental attachment. Key diagnostic features include loss of the retroplacental clear zone and placental lacunae. Routine prenatal care may include such imaging for women at higher risk, especially those with a history of uterine surgery or placenta previa.

Treatment Protocols: The management of placenta accreta usually requires a multidisciplinary approach. Planned delivery often involves surgical intervention, such as a cesarean hysterectomy, particularly if the placenta does not detach spontaneously after delivery. In less severe cases, conservative management with efforts to preserve the uterus might be considered, but these are less common and depend on the individual situation. Blood transfusions may be necessary due to the potential for significant bleeding. Postoperative care involves close monitoring for hemorrhage and other complications. Preventive strategies focus on early detection and planning delivery in specialized centers equipped to handle complex obstetric cases.