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Difference between revisions of "Placenta creta"
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'''Placenta creta''' is an uncommon pathology of [[placenta|placental]] attachment. | |||
==General== | |||
*What? | |||
**Trophoblastic tissue deeper than it should be, so the placenta fails to separate at time of delivery | |||
*Clinical? | |||
**Failure of placenta to deliver spontaneously. | |||
**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> | |||
**May be associated with antepartum hemorrhage. | |||
**Discovered on ultrasound during pregnancy, especially when associated with placenta previa | |||
*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=== | |||
*Placenta (i.e. trophoblastic tissue) extends into the myometrium but not through.<ref name=pmid26002174>{{Cite journal | last1 = Silver | first1 = RM. | last2 = Barbour | first2 = KD. | title = Placenta Accreta Spectrum: Accreta, Increta, and Percreta. | journal = Obstet Gynecol Clin North Am | volume = 42 | issue = 2 | pages = 381-402 | month = Jun | year = 2015 | doi = 10.1016/j.ogc.2015.01.014 | PMID = 26002174 }}</ref> | |||
===Placenta percreta=== | |||
*Trophoblastic tissue penetrates through the myometrium. | |||
==Sign out== | |||
<pre> | |||
PLACENTA, UMBILICAL CORD AND FETAL MEMBRANES, BIRTH: | |||
- PLACENTAL DISC WITH THIRD TRIMESTER VILLI WITHIN NORMAL LIMITS, AND A | |||
DISRUPTED MATERNAL SURFACE COMPATIBLE WITH A HISTORY OF PLACENTA ACCRETA. | |||
- THREE VESSEL UMBILICAL CORD WITHIN NORMAL LIMITS. | |||
- FETAL MEMBRANES WITHIN NORMAL LIMITS. | |||
</pre> | |||
==See also== | |||
*[[Placenta]]. | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Placenta]] | |||