Fetal and Maternal Outcome of Management of Patients with placenta Accreta at Ain Shams Maternity Hospital A Retrospective Analysis of Last Five Years Admissions

Abstract

Placenta accreta occurs when the chorionic villi invade the myometrium abnormally. It is divided into three grades based on histopathology: In placenta accreta, the anchoring villi attach to the myometrium; in placenta increta, the villi invade into the myometrium; and in placenta percreta, the villi penetrate to or through the uterine serosa and may invade surrounding organs. The incidence of placenta accreta has been steadily increasing, mirroring increased rates of caesarean delivery. The most important risk factor for placenta accreta is placenta previa after a prior cesarean delivery. Other predisposing factors have been identified including: multiparity, previous uterine surgery, advanced maternal age and previous uterine curettage. The first clinical manifestation of placenta accreta is usually profuse, life-threatening hemorrhage that occurs at the time of attempted manual placental separation. Part or all of the placenta remains strongly adherent to the uterine cavity, and no plane of separation can be developed. The severe uterine hemorrhage may lead to the need of extensive life-saving surgical interventions such as Hysterectomy and Ligation of  Summary 100 major pelvic vessels. Placenta accreta has become the leading