Skip to main content

What is Placenta Adherence-Acreta–Inccreta and Percreta–Management

Placenta Adherens - Placenta Acreta, Increta, and Percreta:retained placenta removal 2
In these conditions whole or part of the placenta is adherent to the uterine wall due to an invasion of myometrium with chorionic villi which make expulsion of placenta out of the uterus difficult.

Adherent Placenta or Placenta Adherens

Placenta adherens is a condition in which placenta remains attached to the uterine wall for an abnormally long time following birth.

Causes Of Adherent Placenta:

1. Uterine Contraction is necessary for placental separation. any deficiency or incoordination of uterine contraction may make placenta difficult to separate.
2. Uterine anomalies: An abnormally shaped uterus can prevent the placenta from being expelled.
3. Hormonal Causes: During childbirth, the hormone oxytocin is released into the blood. Oxytocin is a potent hormone which induces powerful uterine contraction which helps in placental separation as well. If for some reason, adrenaline is released into the blood (adrenaline is a hormone released into the blood during “fight or flight” response) oxytocin release can be inhibited and therefore prevent the uterus from contracting.

Management Of Placenta Adherens

Agents that help to amplify uterine contraction are administered via umbilical vein. As it is stated earlier that uterine contractions help in placental separation. Therefore, in most of the cases, placenta comes out of the uterus after administration of uterotonic agents. Currently, this is first-line therapy recommended by WHO (March 2012)
If placenta fails to come out after drug therapy, manual separation of placenta would be necessary.

Placenta Accreta:

In placenta accreta chorionic villi are in contact with the myometrium instead of being contained within the decidua.

Placenta Increta:

In placenta Increta there is an extensive invasion of chorionic villi into the myometrium. Which is a more severe condition than placenta acreta.

Placenta percreta:

In this condition, chorionic villous invasion extends to the serosal covering (that is the outer covering) of the uterus. This condition is the most severe among the three.

All these three conditions are usually found in those patients who have previous history of uterine surgery or caesarean section.


Hysterectomy is the procedure of choice if women have no intentions of bearing  further children.
Other measure include:
1. excision or scrapping of the site of trophoblastic invasion.
2. Uterine or internal artery ligation may be helpful.

See also:

1. Complications Of third Stage Of Labour:

2. Primary Post Partum Hemorrhage

3. Uterine Rupture and Scar Dehiscence

4. Uterine Inversion – Etiology, Management and Treatment.


Popular posts from this blog

Human Parasites, Types of Parasites, and Classification

Parasite: A parasite is a living organism which gets nutrition and protection from another organism where it lives. Parasites enter into the human body through mouth, skin and genitalia. In this article, we will generally discuss the types and classification of parasites. It is important from an academic point of view. Those parasites are harmful, which derives their nutrition and other benefits from the host and host get nothing in return but suffers from some injury. Types of Parasites Ecto-parasite: An ectoparasite lives outside on the surface of the body of the host. Endo-parasite: An endo-parasite lives inside the body of the host, it lives in the blood, tissues, body cavities, digestive tract or other organs. Temporary parasite: A temporary parasite visits its host for a short period of time. Permanent parasite: Permanent parasite lives its whole life in the host. Facultative parasite: A facultative parasite can live both independently and dependently. It lives in the

How to taper off, wean off beta blocker, atenolol, Propranolol, Metoprolol

Beta blockers include, atenolol (Tenormin), propranolol (Inderal ) and metoprolol (Lopressor) and are used to treat high blood pressure, certain cardiac problems, migraine and few other conditions. People usually take atenolol, propranolol or metoprolol for many years as a treatment of high blood pressure or after having an episode of heart attack . Sometimes, it becomes necessary to withdraw these beta blockers due to their potential side effects that trouble the patients or sometimes doctor wants to change the drug and shift the patient to some other anti-hypertensive medicine. No matter whatever the cause is, whenever, a patient who has been using a beta blocker for a long period of time, and he needs to be stopped from further usage of that beta blocker, must not stop taking it. One should taper off the dose of a beta blocker. Now a question arises how to wean off or taper off a beta blocker? The method of tapering off beta blocker varies from individual to individual. Allow you

Difficulty in standing up from a sitting or squatting position, Causes & Solution

People who feel it difficult to stand up from a sitting or squatting position may have problem in one or more of the following structures. 1. Knee joint 2. Muscles of legs, thighs or buttock 3. Muscles of arms 4. Cerebellum Let’s now explain one by one, what kind of problems in above structures may cause difficulty in standing up from a sitting or squatting position. 1. How do problems in knee joints lead to difficulty in standing up? Knee joint is one of the primary and most affected joint that takes part in standing up. Other joints that take part are hip, ankle, knee, elbow, wrist and shoulder joint. Knee joint gets the most strain , and also knee joint is comparatively less supported. That’s why usually it’s the knee joint that starts to cry first because of arthritis. Knee joint arthritis causes long term knee pain , that makes the movement difficult at knee joint. Arthritis also makes the knee joint stiffer and slower and its range of motion also decreases. All these affects coll