Morbidly adherent placenta

Abstract 

Morbidly adherent placenta describes an abnormality in the adherence of the placenta to the myometrium. It can be a cause of massive haemorrhage resulting in severe morbidity and mortality. The incidence appears increased over the recent years probably due to the increased caesarean delivery rates. The identification of women with risk factors is very important for the early diagnosis and management. Morbidly adherent placenta can be diagnosed by ultrasound scan or MRI. Although traditionally obstetric hysterectomy has been the standard treatment, various conservative measures have been developed in order to avoid hysterectomy and preserve fertility. A multidisciplinary approach with surgical expertise, availability of transfusion facilities and further interventions including interventional radiology is essential and may result in reduced maternal morbidity and mortality. The aim of this review is to illustrate the salient points in the management of these patients based on different clinical scenarios.

Keywords: accreta, diagnosis, increta, management, morbidly adherent placenta, percreta