Christopher Robinson: AJOG Expert Review on Placenta Accreta After Cesarean
Christopher Robinson, Associate Professor Maternal Fetal Medicine at University of South Carolina, shared a post on LinkedIn:
“AJOG Expert Review in Cesarean: What is placenta accreta? Uterine cavity with retained placental tissue; before and after surgical evacuation
Transvaginal ultrasound images in a case of partial placenta retention, 6 weeks after an elective cesarean section at term, in a primiparous patient with no history of other uterine surgical procedure. The postpartum was complicated with severe hemorrhage for which an emergency curettage procedure was performed 24 hours after delivery, followed by uterine atony requiring uterotonics, massive blood transfusion (>10 units), and admission to the intensive care unit.
Three weeks after delivery, the patient presented with a new episode of heavy bleeding and an ultrasound examination showing retained placental tissue. A hysteroscopic resection procedure and second curettage were performed but failed, and the patient was informed that this was due to a complication of ‘placenta accreta.’ Left: view of the uterus containing an echogenic mass near the uterine (F), 35 mm in diameter, suggesting retained placental tissue; right: view of the uterus, gentle sponge forceps removal vacuum aspiration under ultrasound guidance showing an empty uterine cavity. Note the presence of 2.1 mm cesarean scar defect (arrow).
Cx, cervix; F, fundus of the uterus; P, placenta.”
Title: What is placenta accreta?
Author: Eric Jauniaux, Brett D. Einerson, Ahmed M. Hussein, Robert M. Silver, Graham J. Burton
Read the full article.
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