A. DESCRIPTION. Placenta accrete is an uncommon condition in which the chorionic villi adhere to the myometrium. It can be exhibited as:
1. Placenta Accreta – the placental chorionic will adhere to the superficial layer of the uterine myometrium.
2. Placenta Increta – the placental chorionic will invade deeply into the uterine myometrium.
3. Placenta Pecreta – the placental chorionic will go through the uterine myometrium and often adhere to abdominal structures such as the bladder or intestine)
B. ETIOLOGY. Predisposing factors are prior uterine surgery and placenta previa.
C. PATHOPHYSIOLOGY. Implantation in an area of defective endometrium with no zone separation between the placenta and the myometrium.
D. ASSESSMENT FINDINGS.
1.Associated findings. Placenta accrete is usually diagnosed in the immediate postpartum period when the placenta fails to separate.
2. Clinical manifestations
a. Placenta fails to separate
b. Profuse hemorrhage may result depending on the portion of placenta involved.
E. NURSING MANAGEMENT
1.Identify placenta accrete in the client. Be aware of the client’s risk status.
2. Assist with rapid treatment and intervention. Be prepared for a dilation and curettage or hysterectomy.
3. Provide physical and emotional support.
4. Provide client and family education.