Difference between revisions of "Placenta creta"

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#redirect [[Placenta#Placenta_creta]]
'''Placenta creta''' is an uncommon pathology of [[placenta|placental]] attachment.
 
==General==
*What?
**Trophoblastic tissue deeper than it should be.
*Clinical?
**Postpartum hemorrhage leading to a hysterectomy.<ref name=pmid18514815>{{Cite journal  | last1 = Tantbirojn | first1 = P. | last2 = Crum | first2 = CP. | last3 = Parast | first3 = MM. | title = Pathophysiology of placenta creta: the role of decidua and extravillous trophoblast. | journal = Placenta | volume = 29 | issue = 7 | pages = 639-45 | month = Jul | year = 2008 | doi = 10.1016/j.placenta.2008.04.008 | PMID = 18514815 }}</ref>
*Pathogenesis?
**It is suspected that it arises as there is defect in the endometrium/myometrium -- ''not'' deep trophoblastic invasion.<ref name=pmid18514815/>
**Risk factors:<ref name=pmid23466142>{{Cite journal  | last1 = Wortman | first1 = AC. | last2 = Alexander | first2 = JM. | title = Placenta accreta, increta, and percreta. | journal = Obstet Gynecol Clin North Am | volume = 40 | issue = 1 | pages = 137-54 | month = Mar | year = 2013 | doi = 10.1016/j.ogc.2012.12.002 | PMID = 23466142 }}</ref>
***Placenta previa.
***Previous caesarian section.
 
Note:
*Normal: trophoblastic tissue attaches to the decidua.<ref name=Ref_Pathde_974>{{Ref Pathde|974}}</ref>
*Retained placentas have less multinucleated trophoblastic giant cells.<ref name=pmid19734475>{{Cite journal  | last1 = van Beekhuizen | first1 = HJ. | last2 = Joosten | first2 = I. | last3 = de Groot | first3 = AN. | last4 = Lotgering | first4 = FK. | last5 = van der Laak | first5 = J. | last6 = Bulten | first6 = J. | title = The number of multinucleated trophoblastic giant cells in the basal decidua is decreased in retained placenta. | journal = J Clin Pathol | volume = 62 | issue = 9 | pages = 794-7 | month = Sep | year = 2009 | doi = 10.1136/jcp.2009.065953 | PMID = 19734475 }}</ref>
===Placenta accreta===
*Trophoblastic tissue (directly) adherent to the myometrium.<ref name=Ref_Pathde_974>{{Ref Pathde|974}}</ref>
 
Image:
*[http://library.med.utah.edu/WebPath/jpeg2/PLAC040.jpg Placenta accreta (med.utah.edu)].<ref>URL: [http://library.med.utah.edu/WebPath/EXAM/IMGQUIZ/plfrm.html http://library.med.utah.edu/WebPath/EXAM/IMGQUIZ/plfrm.html]. Accessed on: 3 December 2011.</ref>
*[http://www.flickr.com/photos/lunarcaustic/4114362341/ Placenta accreta (flickr.com/lunar caustic)].
 
===Placenta increta===
*Trophoblastic tissue extends into the myometrium.
 
===Placenta percreta===
*Trophoblastic tissue penetrates through the myometrium.
 
==See also==
*[[Placenta]].
 
==References==
{{Reflist|2}}
 
[[Category:Placenta]]

Revision as of 19:56, 17 June 2014

Placenta creta is an uncommon pathology of placental attachment.

General

  • What?
    • Trophoblastic tissue deeper than it should be.
  • Clinical?
    • Postpartum hemorrhage leading to a hysterectomy.[1]
  • Pathogenesis?
    • It is suspected that it arises as there is defect in the endometrium/myometrium -- not deep trophoblastic invasion.[1]
    • Risk factors:[2]
      • Placenta previa.
      • Previous caesarian section.

Note:

  • Normal: trophoblastic tissue attaches to the decidua.[3]
  • Retained placentas have less multinucleated trophoblastic giant cells.[4]

Placenta accreta

  • Trophoblastic tissue (directly) adherent to the myometrium.[3]

Image:

Placenta increta

  • Trophoblastic tissue extends into the myometrium.

Placenta percreta

  • Trophoblastic tissue penetrates through the myometrium.

See also

References

  1. 1.0 1.1 Tantbirojn, P.; Crum, CP.; Parast, MM. (Jul 2008). "Pathophysiology of placenta creta: the role of decidua and extravillous trophoblast.". Placenta 29 (7): 639-45. doi:10.1016/j.placenta.2008.04.008. PMID 18514815.
  2. Wortman, AC.; Alexander, JM. (Mar 2013). "Placenta accreta, increta, and percreta.". Obstet Gynecol Clin North Am 40 (1): 137-54. doi:10.1016/j.ogc.2012.12.002. PMID 23466142.
  3. 3.0 3.1 Böcker, Werner; Denk, Helmut; Heitz, Philipp U.; Moch, Holger (2008). [Pathologie] (4th ed.). Urban & Fischer Verlag/Elsevier GmbH. pp. 974. ISBN 978-3437423826.
  4. van Beekhuizen, HJ.; Joosten, I.; de Groot, AN.; Lotgering, FK.; van der Laak, J.; Bulten, J. (Sep 2009). "The number of multinucleated trophoblastic giant cells in the basal decidua is decreased in retained placenta.". J Clin Pathol 62 (9): 794-7. doi:10.1136/jcp.2009.065953. PMID 19734475.
  5. URL: http://library.med.utah.edu/WebPath/EXAM/IMGQUIZ/plfrm.html. Accessed on: 3 December 2011.